MEDICARE: SA OPERATIONS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility	NH5529	OK

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	375561	OTHER	OK	MEDICARE

General Provider Information

NPI Number	:	1043798069
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SA OPERATIONS LLC

Provider Business Mailing Address
First Line	:	9400 SAINT ANN DR
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73162-6400
Country	:	US
Telephone Number	:	405-728-7888
Fax Number	:	405-728-1302

Provider Business Practice Location Address
First Line	:	9400 SAINT ANN DR
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73162-6400
Country	:	US
Telephone Number	:	405-728-7888
Fax Number	:	405-728-1302

Authorized Official
Title or Position	:	DIRECTOR OF REIMBURSEMENT
Name	:	KRISTY DEROIN
Credential	:	MBA
Telephone Number	:	405-943-1144

Provider Enumeration Date	:	08/01/2018
Last Update Date	:	10/14/2025

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Directions to “SA OPERATIONS LLC ” Practice Location

Language	Start Address	Practice Location

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