Provider Demographics
NPI:1578023958
Name:PHARMACY PROVIDERS OF OKLAHOMA INC
Entity Type:Organization
Organization Name:PHARMACY PROVIDERS OF OKLAHOMA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAXWELL
Authorized Official - Suffix:
Authorized Official - Credentials:MHP, MPH
Authorized Official - Phone:405-557-5755
Mailing Address - Street 1:3000 E MEMORIAL RD
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-7000
Mailing Address - Country:US
Mailing Address - Phone:405-557-5700
Mailing Address - Fax:
Practice Address - Street 1:3000 E MEMORIAL RD
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-7000
Practice Address - Country:US
Practice Address - Phone:405-557-5700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-22
Last Update Date:2019-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy