Provider Demographics
NPI:1629086509
Name:CHELSEA FAMILY PHARMACY, PLLC
Entity Type:Organization
Organization Name:CHELSEA FAMILY PHARMACY, PLLC
Other - Org Name:CHELSEA FAMILY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:918-789-2241
Mailing Address - Street 1:600 WALNUT ST.
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:OK
Mailing Address - Zip Code:74016
Mailing Address - Country:US
Mailing Address - Phone:918-789-2241
Mailing Address - Fax:918-789-3705
Practice Address - Street 1:600 WALNUT ST.
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:OK
Practice Address - Zip Code:74016
Practice Address - Country:US
Practice Address - Phone:918-789-2241
Practice Address - Fax:918-789-3705
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHELSEA FAMILY PHARMACY, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-04
Last Update Date:2012-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKOKB6015OtherPTAN
OK200006070BMedicaid
OKOKB6015OtherPTAN
OK4895460001Medicare Oscar/Certification
OK1629086509Medicare NSC
4895460001Medicare UPIN