Provider Demographics
NPI:1235775628
Name:SAINTS MEDICAL GROUP, LLC
Entity type:Organization
Organization Name:SAINTS MEDICAL GROUP, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:SHASTA
Authorized Official - Middle Name:
Authorized Official - Last Name:MANUEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-272-7282
Mailing Address - Street 1:13500 S TULSA DR STE 301
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73170-9721
Mailing Address - Country:US
Mailing Address - Phone:405-793-2900
Mailing Address - Fax:405-578-3299
Practice Address - Street 1:13500 S TULSA DR STE 301
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73170-9721
Practice Address - Country:US
Practice Address - Phone:405-793-2900
Practice Address - Fax:405-578-3299
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SSM HEALTH CARE OF OKLAHOMA, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-11-21
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty