Provider Demographics
NPI:1598164287
Name:LANG, ALLISON RACHEL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:RACHEL
Last Name:LANG
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 1:12273 N 167TH EAST AVE
Mailing Address - Street 2:
Mailing Address - City:COLLINSVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74021-5899
Mailing Address - Country:US
Mailing Address - Phone:314-610-3692
Mailing Address - Fax:
Practice Address - Street 1:10019 S MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-6103
Practice Address - Country:US
Practice Address - Phone:918-615-5001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-19
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK15796183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist