Provider Demographics
NPI:1962842062
Name:MEDCARE UNITED CHARITABLE PHARMACY INC.
Entity Type:Organization
Organization Name:MEDCARE UNITED CHARITABLE PHARMACY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TAMBERLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:HERD
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:405-271-6278
Mailing Address - Street 1:711 STANTON L YOUNG BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73104-5023
Mailing Address - Country:US
Mailing Address - Phone:405-271-6278
Mailing Address - Fax:405-271-6287
Practice Address - Street 1:711 STANTON L YOUNG BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-5023
Practice Address - Country:US
Practice Address - Phone:405-271-6278
Practice Address - Fax:405-271-6287
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-03
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1-5412251V00000X, 333600000X, 3336C0002X, 3336C0003X, 3336M0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No251V00000XAgenciesVoluntary or Charitable
No333600000XSuppliersPharmacy
No3336C0002XSuppliersPharmacyClinic Pharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy