SCG Madill Brookside LLC

Skilled Nursing Facility · Madill, OK

Organization Active NPI

NPI number 1699764100

Practice location

310 Brookside Dr
Highway 377
Madill, OK 73446-9047
Phone
(580) 795-2100
Fax
(580) 677-9918

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NPI record

NPI
1699764100
Entity type
Organization (Type 2)
Enumeration date
October 18, 2005
Last updated
July 17, 2014
Organization subpart
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Skilled Nursing Facility Primary 314000000X NH4801-4801 OK

Mailing address

1240 Marbella Plaza Dr.
Tampa, FL 33619-7905
Phone
(813) 341-2700
Fax
(813) 676-0127

Authorized official

Name
Mr. Kevin C Goyer Jr.
Title
President
Phone
(813) 341-2700

Other names

  • Brookside Nursing Center

About SCG Madill Brookside LLC

SCG Madill Brookside LLC is a healthcare organization registered in the NPI registry with the primary taxonomy Skilled Nursing Facility (code 314000000X). The practice location is 310 Brookside Dr, Highway 377, Madill, OK 73446-9047. The NPI number 1699764100 was assigned on October 18, 2005 and the record was last updated on July 17, 2014.

SCG Madill Brookside LLC lists a license in the registry: #NH4801-4801 (OK) for Skilled Nursing Facility. License numbers are self-reported to NPPES; verify them with the state licensing board.

The authorized official for this organization is Mr. Kevin C Goyer Jr., President.

Frequently asked questions

What is the NPI number of SCG Madill Brookside LLC?

The NPI number is 1699764100.

What is the phone number of SCG Madill Brookside LLC?

The phone number listed for the practice location is (580) 795-2100.

Where is SCG Madill Brookside LLC located?

310 Brookside Dr, Highway 377, Madill, OK 73446-9047.

What is the taxonomy code for SCG Madill Brookside LLC?

The primary taxonomy code is 314000000X – Skilled Nursing Facility.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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