Provider Demographics
NPI:1619061330
Name:SAK INC
Entity Type:Organization
Organization Name:SAK INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DOROTHEA
Authorized Official - Middle Name:
Authorized Official - Last Name:EMAMIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RD/LD
Authorized Official - Phone:405-694-8242
Mailing Address - Street 1:4600 KAREN DRIVE
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-8143
Mailing Address - Country:US
Mailing Address - Phone:405-694-8242
Mailing Address - Fax:
Practice Address - Street 1:4600 KAREN DRIVE
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-8143
Practice Address - Country:US
Practice Address - Phone:405-694-8242
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK27133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty