Provider Demographics
NPI:1851943898
Name:TRB DRUGRY INC
Entity Type:Organization
Organization Name:TRB DRUGRY INC
Other - Org Name:TRB DRUGRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:E
Authorized Official - Last Name:OSBORN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-743-6623
Mailing Address - Street 1:PO BOX 31
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:OK
Mailing Address - Zip Code:74355-0031
Mailing Address - Country:US
Mailing Address - Phone:918-542-4444
Mailing Address - Fax:
Practice Address - Street 1:3404 S YALE AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-8016
Practice Address - Country:US
Practice Address - Phone:918-743-6623
Practice Address - Fax:918-743-6654
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-10
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3730581OtherNCPDP
OK200847430AMedicaid
OK2-8499OtherOKLAHOMA BOARD OF PHARMACY
OK68064OtherOBN
OK200847430BMedicaid
OK200847430BMedicaid