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Contact Information

TIMBERLANE MANOR, LLC
2520 SOUTH RANKIN
EDMOND, OK73013
 Phone: 405-341-1433
 Fax: 405-562-2128
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Skilled Nursing Facility

314000000X A1[8] Skilled Nursing Facility
Indicates primary specialty

NPI Profile & details for TIMBERLANE MANOR, LLC

NPI # 1255425898
LBN Legal business name TIMBERLANE MANOR, LLC
Authorized official KRISTY DEROIN - (DIRECTOR OF REIMBURSEMENT)
Entity Organization
Organization subpart 1 No
Enumeration date 10/03/2006
Last updated 10/14/2025 - About 8 months ago
Identifiers
OK License # NH5536-5536
OK Medicaid 100810270B
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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