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NPI Code Detail

MEDICARE: FMC PHARMACY LLC

MEDICARE: FMC PHARMACY LLC
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
1333600000XPharmacy
23336L0003XLong Term Care Pharmacy
33336C0002XClinic Pharmacy2-4962OK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
32076980OTHERPK

General Provider Information

NPI Number : 1124049192
Entity Type Code : Organization
Provider Name (Legal Business Name) : FMC PHARMACY LLC
Provider Business Mailing Address
First Line : LOCK BOX
Second Line : DEPT 2113
City : TULSA
State : OK
Zip : 74182-0001
Country : US
Telephone Number : 918-712-3407
Fax Number : 918-712-3408
Provider Business Practice Location Address
First Line : 2325 S HARVARD AVE
Second Line : STE 400
City : TULSA
State : OK
Zip : 74114-3300
Country : US
Telephone Number : 918-712-3407
Fax Number : 918-712-3408
Authorized Official
Title or Position : PIC
Name : LISA OWENS
Credential : DPH
Telephone Number : 918-712-3407
Provider Enumeration Date : 07/22/2006
Last Update Date : 09/19/2025

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Directions to “FMC PHARMACY LLC ” Practice Location

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