Provider Demographics
NPI:1083014161
Name:SHERWOOD HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:SHERWOOD HEALTH SERVICES LLC
Other - Org Name:SHERWOOD MANOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:VERNIE
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:HOLLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-446-4285
Mailing Address - Street 1:PO BOX 760
Mailing Address - Street 2:
Mailing Address - City:GORE
Mailing Address - State:OK
Mailing Address - Zip Code:74435-0760
Mailing Address - Country:US
Mailing Address - Phone:918-446-4285
Mailing Address - Fax:918-445-8811
Practice Address - Street 1:2416 W 51ST ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74107-7700
Practice Address - Country:US
Practice Address - Phone:918-446-4285
Practice Address - Fax:918-445-8811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-26
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK375556Medicare Oscar/Certification