OrganizationOk4 Eastgate Opco Llc(Eastgate Village Retirement Center)Skilled Nursing FacilityNursing & Custodial Care FacilitiesPractice Address3500 Haskell Blvd, Muskogee, OK 74403-3915(918) 682-3191PECOS EnrollmentBased on the most recent information from CMS, provider Ok4 Eastgate Opco Llc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1962857482Provider TypeOrganizationFull NameOk4 Eastgate Opco LlcOther NameEastgate Village Retirement CenterSubpartNoEnumeration Date5/3/2016Last Updated5/27/2016Contact InformationPractice LocationPractice Address3500 Haskell Blvd, Muskogee, OK 74403-3915Phone(918) 682-3191FaxUnlisted FaxMailing LocationMailing Address3500 Haskell Blvd, Muskogee, OK 74403-3915Phone(918) 682-3191FaxUnlisted FaxAuthorized OfficialNameDole, Isaac (Manager/Principal)Phone(312) 724-8950Provider TaxonomiesCodeDescriptionLicenseCode314000000XPrimaryDescriptionSkilled Nursing FacilityNursing & Custodial Care FacilitiesLicenseUnlisted IssuerOklahoma