Provider Demographics
NPI:1316337330
Name:ER OPCO ML LLC
Entity type:Organization
Organization Name:ER OPCO ML LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:J
Authorized Official - Last Name:COATES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-915-2932
Mailing Address - Street 1:16044 COUNTY ROAD 165
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-7302
Mailing Address - Country:US
Mailing Address - Phone:903-526-5599
Mailing Address - Fax:903-526-3717
Practice Address - Street 1:16044 COUNTY ROAD 165
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-7302
Practice Address - Country:US
Practice Address - Phone:903-526-5599
Practice Address - Fax:903-526-3717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-28
Last Update Date:2017-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX676286Medicare Oscar/Certification