Provider Demographics
NPI:1689738726
Name:CHELSEA FAMILY PHARMACY, LLC
Entity Type:Organization
Organization Name:CHELSEA FAMILY PHARMACY, LLC
Other - Org Name:CHELSEA FAMILY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:P.
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-789-2241
Mailing Address - Street 1:406 W 6TH ST
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:OK
Mailing Address - Zip Code:74016-1640
Mailing Address - Country:US
Mailing Address - Phone:918-789-2241
Mailing Address - Fax:918-789-3705
Practice Address - Street 1:406 W 6TH ST
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:OK
Practice Address - Zip Code:74016-1640
Practice Address - Country:US
Practice Address - Phone:918-789-2241
Practice Address - Fax:918-789-3705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK29-46973336C0003X, 3336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Not Answered3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK4895460001Medicare ID - Type Unspecified