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PROVIDENCE RX INC NPI 1225518079


NPI Information

NPI: 1225518079
Provider Name: PROVIDENCE RX INC

Doing Business As: PROVIDENCE RX PHARMACY

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

CLIA Number: 37D2187849

Address:
7302 S YALE AVE STE 101
TULSA, OK
ZIP 74136
Phone: (918) 392-3366
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PROVIDENCE RX INC is a community/retail pharmacy pharmacy in Tulsa, OK. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. PROVIDENCE RX INC NPI is 1225518079. The provider is registered as an organization entity type.
The provider Is Doing Business As Providence Rx Pharmacy.

The provider's business location address is:

7302 S YALE AVE STE 101
TULSA, OK
ZIP 74136-032
Phone: (918) 392-3366
Fax: (918) 392-2950

The provider's authorized official is Lisa Aileen Owens .
The authorized official title is President and has the following contact phone number (918) 808-6228.

The CLIA number assigned to this NPI record is 37D2187849 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/20/2018 and was last updated on 3/4/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1291U00000XClinical Medical LaboratoryNo
23336L0003XPharmacyLong Term Care PharmacyNo
33336C0003XPharmacyCommunity/Retail PharmacyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1200785950AMEDICAIDOKLAHOMA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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