Provider Demographics
NPI:1619914041
Name:REASORS LLC
Entity Type:Organization
Organization Name:REASORS LLC
Other - Org Name:REASOR'S PHARMACY #23
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGEHEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-947-8180
Mailing Address - Street 1:200 W CHOCTAW ST
Mailing Address - Street 2:
Mailing Address - City:TAHLEQUAH
Mailing Address - State:OK
Mailing Address - Zip Code:74464-3808
Mailing Address - Country:US
Mailing Address - Phone:918-947-8180
Mailing Address - Fax:918-947-8199
Practice Address - Street 1:3328 E 51ST ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-3512
Practice Address - Country:US
Practice Address - Phone:918-743-5782
Practice Address - Fax:918-747-0338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 3336C0004X
OK2-64123336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2142015OtherPK
OK200114270DMedicaid