Provider Demographics
NPI:1013338946
Name:SCHEFFE RX INC
Entity Type:Organization
Organization Name:SCHEFFE RX INC
Other - Org Name:SCHEFFE PRESCRIPTION SHOP WEST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OSBORN
Authorized Official - Prefix:
Authorized Official - First Name:BILL
Authorized Official - Middle Name:
Authorized Official - Last Name:OSBORN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-542-4444
Mailing Address - Street 1:1925 W OWEN K GARRIOTT RD
Mailing Address - Street 2:
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73703-5528
Mailing Address - Country:US
Mailing Address - Phone:580-242-3784
Mailing Address - Fax:580-237-4199
Practice Address - Street 1:1925 W OWEN K GARRIOTT RD
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73703-5528
Practice Address - Country:US
Practice Address - Phone:580-242-3784
Practice Address - Fax:580-237-4199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-19
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336L0003X
OK5-65313336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200122690GMedicaid
2143826OtherPK