Provider Demographics
NPI:1528104130
Name:PHARMACY SOLUTIONS LLC
Entity type:Organization
Organization Name:PHARMACY SOLUTIONS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:OLIVER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:405-948-4602
Mailing Address - Street 1:PO BOX 270214
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73137-0214
Mailing Address - Country:US
Mailing Address - Phone:405-948-4602
Mailing Address - Fax:405-512-6900
Practice Address - Street 1:4350 WILL ROGERS PKWY
Practice Address - Street 2:STE 200
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73108-1826
Practice Address - Country:US
Practice Address - Phone:405-948-4602
Practice Address - Fax:405-512-6900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2016-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
OK1-46653336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK90003930302Medicaid
OK100245150AMedicaid
2076095OtherPK