Provider Demographics
NPI:1467661413
Name:JIMRX, PC
Entity Type:Organization
Organization Name:JIMRX, PC
Other - Org Name:EXCHANGE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:RHYMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-235-4242
Mailing Address - Street 1:2300 EXCHANGE AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73108-2436
Mailing Address - Country:US
Mailing Address - Phone:405-235-4242
Mailing Address - Fax:405-239-7507
Practice Address - Street 1:2300 EXCHANGE AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73108-2436
Practice Address - Country:US
Practice Address - Phone:405-235-4242
Practice Address - Fax:405-239-7507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1-41743336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2081556OtherPK
OK100244730AMedicaid