Healthcare Provider Details

I. General information

NPI: 1043798069
Provider Name (Legal Business Name): SA OPERATIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2018
Last Update Date: 10/14/2025
Certification Date: 10/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9400 SAINT ANN DR
OKLAHOMA CITY OK
73162-6400
US

IV. Provider business mailing address

9400 SAINT ANN DR
OKLAHOMA CITY OK
73162-6400
US

V. Phone/Fax

Practice location:
  • Phone: 405-728-7888
  • Fax: 405-728-1302
Mailing address:
  • Phone: 405-728-7888
  • Fax: 405-728-1302

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberNH5529
License Number StateOK

VIII. Authorized Official

Name: KRISTY DEROIN
Title or Position: DIRECTOR OF REIMBURSEMENT
Credential: MBA
Phone: 405-943-1144