Provider Demographics
NPI:1033291836
Name:SCOTT ROBISONS RX INC
Entity Type:Organization
Organization Name:SCOTT ROBISONS RX INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:
Authorized Official - Last Name:WINKELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-582-7144
Mailing Address - Street 1:1560 E 21ST ST
Mailing Address - Street 2:STE 104
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74114-1351
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1145 S UTICA AVE
Practice Address - Street 2:STE 18
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-4000
Practice Address - Country:US
Practice Address - Phone:918-582-7144
Practice Address - Fax:918-584-1214
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2008-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK229733336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3715969OtherOTHER ID NUMBER-COMMERCIAL NUMBER
3715969OtherOTHER ID NUMBER