MEDICARE: RHONDA MCCOMBS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	34-3763	OK

General Provider Information

NPI Number	:	1033192646
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RHONDA MCCOMBS

Provider Business Mailing Address
First Line	:	PO BOX 1469
Second Line	:	101 EAST BROADWAY
City	:	MULDROW
State	:	OK
Zip	:	74948-1469
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 E SHAWNTEL SMITH BLVD
Second Line	:
City	:	MULDROW
State	:	OK
Zip	:	74948-4416
Country	:	US
Telephone Number	:	918-427-1985
Fax Number	:	918-427-1157

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/29/2005
Last Update Date	:	07/08/2007

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Directions to “ RHONDA MCCOMBS ” Practice Location

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