Provider Demographics
NPI:1104887108
Name:SANS BOIS HEALTH SERVICES, INC.
Entity type:Organization
Organization Name:SANS BOIS HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JIMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:WINKLEPLECK
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:918-967-1001
Mailing Address - Street 1:PO BOX 702
Mailing Address - Street 2:
Mailing Address - City:STIGLER
Mailing Address - State:OK
Mailing Address - Zip Code:74462-0702
Mailing Address - Country:US
Mailing Address - Phone:918-967-1001
Mailing Address - Fax:918-967-1005
Practice Address - Street 1:1505 E MAIN ST STE C
Practice Address - Street 2:
Practice Address - City:STIGLER
Practice Address - State:OK
Practice Address - Zip Code:74462-2804
Practice Address - Country:US
Practice Address - Phone:918-967-1001
Practice Address - Fax:918-967-1005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-29
Last Update Date:2009-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK7705251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100262780Medicaid
OK377635Medicare ID - Type Unspecified