MEDICARE: KINDFUL HOSPICE SAPULPA TULSA, 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	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1669964433
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KINDFUL HOSPICE SAPULPA TULSA, LLC

Provider Business Mailing Address
First Line	:	6760 OLD JACKSONVILLE HWY STE 101
Second Line	:
City	:	TYLER
State	:	TX
Zip	:	75703-0566
Country	:	US
Telephone Number	:	903-363-9932
Fax Number	:	817-326-2436

Provider Business Practice Location Address
First Line	:	8010 S 101ST EAST AVE STE 200
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74133-4562
Country	:	US
Telephone Number	:	918-512-8388
Fax Number	:	918-512-8460

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR OF COMPLIANCE
Name	:	KATIE SANDLIN
Credential	:
Telephone Number	:	903-714-3439

Provider Enumeration Date	:	06/06/2018
Last Update Date	:	07/24/2025

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