Provider Demographics
NPI:1124155486
Name:UNIVERSAL REHAB SERVICES
Entity type:Organization
Organization Name:UNIVERSAL REHAB SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:BLAKE
Authorized Official - Last Name:MURDOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-272-0700
Mailing Address - Street 1:114 N.W. 6TH ST
Mailing Address - Street 2:STE 104
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73102-6089
Mailing Address - Country:US
Mailing Address - Phone:405-272-0700
Mailing Address - Fax:405-272-0701
Practice Address - Street 1:114 N.W. 6TH ST
Practice Address - Street 2:STE 104
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73102-6089
Practice Address - Country:US
Practice Address - Phone:405-272-0700
Practice Address - Fax:405-272-0701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK376611Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER