Provider Demographics
NPI:1154316867
Name:NEO HEALTH CARE INC., DBA OSBORNE CARE & REHAB
Entity type:Organization
Organization Name:NEO HEALTH CARE INC., DBA OSBORNE CARE & REHAB
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DON
Authorized Official - Prefix:MRS
Authorized Official - First Name:YVONNE
Authorized Official - Middle Name:DIANNE
Authorized Official - Last Name:PANTER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:918-540-2300
Mailing Address - Street 1:2530 N ELM ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:OK
Mailing Address - Zip Code:74354-1444
Mailing Address - Country:US
Mailing Address - Phone:918-540-2300
Mailing Address - Fax:918-540-2525
Practice Address - Street 1:2530 N ELM ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:OK
Practice Address - Zip Code:74354-1444
Practice Address - Country:US
Practice Address - Phone:918-540-2300
Practice Address - Fax:918-540-2525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-19
Last Update Date:2007-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKNH5804-5804313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK375335Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER