Provider Demographics
NPI:1588898902
Name:L & L PHARMACY LLC
Entity type:Organization
Organization Name:L & L PHARMACY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:
Authorized Official - Last Name:LASITER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-607-6447
Mailing Address - Street 1:5057 S YALE AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-7010
Mailing Address - Country:US
Mailing Address - Phone:918-394-3784
Mailing Address - Fax:918-392-3321
Practice Address - Street 1:5057 S YALE AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-7010
Practice Address - Country:US
Practice Address - Phone:918-394-3784
Practice Address - Fax:918-392-3321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-13
Last Update Date:2009-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2-54243336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3725720OtherNCPDP PROVIDER IDENTIFICATION NUMBER
3725720OtherNCPDP PROVIDER IDENTIFICATION NUMBER