Provider Demographics
NPI:1659990935
Name:TAMAH, RENE LAHMBE
Entity Type:Individual
Prefix:DR
First Name:RENE
Middle Name:LAHMBE
Last Name:TAMAH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:RENE
Other - Middle Name:LAHMBE
Other - Last Name:TAMAH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHAMD
Mailing Address - Street 1:4722 S 202ND EAST AVE
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74014-8826
Mailing Address - Country:US
Mailing Address - Phone:859-536-2845
Mailing Address - Fax:
Practice Address - Street 1:4722 S 202ND EAST AVE
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74014-8826
Practice Address - Country:US
Practice Address - Phone:859-536-2845
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-16
Last Update Date:2020-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK17889183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist