Provider Demographics
NPI:1437480100
Name:CHURCH, CHELSEA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CHELSEA
Middle Name:
Last Name:CHURCH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 N. LEE, STE 241
Mailing Address - Street 2:SWOSU DEPT. OF PHARM PRACTICE, PASTEUR MEDICAL BLDG
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73103
Mailing Address - Country:US
Mailing Address - Phone:405-272-7232
Mailing Address - Fax:405-601-1201
Practice Address - Street 1:1000 N. LEE
Practice Address - Street 2:ST. ANTHONY HOSPITAL
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73101
Practice Address - Country:US
Practice Address - Phone:405-272-7232
Practice Address - Fax:405-601-1201
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-20
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK123411835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy