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General NPI Number Information
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NPI Number | 1730907700
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Entity Type | Organization
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Legal Business Name | SAINTS MEDICAL GROUP, LLC
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Dates
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Enumeration Date | 09/30/2024
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Last Update Date | 04/10/2025
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Provider Practice Location Address
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Address Line | 2749 PROGRESSIVE DR
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City | EDMOND
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State | OK
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Zip | 73034-7649
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Country | US
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Telephone | 405-772-4110
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Fax |
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Provider Business Mailing Address
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Address Line | 2749 PROGRESSIVE DR
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City | EDMOND
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State | OK
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Zip | 73034-7649
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Country | US
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Telephone | 405-772-4110
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Fax |
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Authorized Official
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Title or Position | VP - FINANCE
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Name | SHASTA RENE MANUEL
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Credential |
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Telephone | 405-272-7282
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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