MEDICARE: TWIN R NO 2 INC

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	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	1-4593	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2072548	OTHER		PK

General Provider Information

NPI Number	:	1043303472
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TWIN R NO 2 INC

Provider Business Mailing Address
First Line	:	PO BOX 10763
Second Line	:
City	:	MIDWEST CITY
State	:	OK
Zip	:	73140-1763
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	249 N DOUGLAS BLVD
Second Line	:
City	:	MIDWEST CITY
State	:	OK
Zip	:	73130-3309
Country	:	US
Telephone Number	:	405-741-4411
Fax Number	:	405-733-7260

Authorized Official
Title or Position	:	MANAGER
Name	:	MACVICTOR VIET KY NGUYEN
Credential	:
Telephone Number	:	405-741-4411

Provider Enumeration Date	:	09/30/2006
Last Update Date	:	02/10/2025

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Directions to “TWIN R NO 2 INC ” Practice Location

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