Provider Demographics
NPI:1841002243
Name:SANA WOUND CARE OKLAHOMA, LLC
Entity type:Organization
Organization Name:SANA WOUND CARE OKLAHOMA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATINKA
Authorized Official - Middle Name:
Authorized Official - Last Name:VAN DER MERWE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:479-480-6677
Mailing Address - Street 1:18 W COLT SQUARE DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703
Mailing Address - Country:US
Mailing Address - Phone:479-480-6677
Mailing Address - Fax:479-485-3752
Practice Address - Street 1:3150 E 41ST ST STE 108A
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74105-3739
Practice Address - Country:US
Practice Address - Phone:479-480-6677
Practice Address - Fax:479-485-3752
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-22
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WW0000XNursing Service ProvidersRegistered NurseWound CareGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty