Provider Demographics
NPI:1124473103
Name:ML-OP OXFORD, LLC
Entity type:Organization
Organization Name:ML-OP OXFORD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT, CHIEF FINANCIAL OFF
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:L
Authorized Official - Last Name:HINES
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:620-257-6700
Mailing Address - Street 1:PO BOX 509
Mailing Address - Street 2:
Mailing Address - City:COFFEYVILLE
Mailing Address - State:KS
Mailing Address - Zip Code:67337-0509
Mailing Address - Country:US
Mailing Address - Phone:620-709-0342
Mailing Address - Fax:
Practice Address - Street 1:200 S OHIO
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:KS
Practice Address - Zip Code:67119-8080
Practice Address - Country:US
Practice Address - Phone:620-455-2214
Practice Address - Fax:620-455-2497
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-27
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSN096005314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS175450Medicare Oscar/Certification