MEDICARE: DR. VALERIE RENEE PENNINGTON PHARM.D.

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	1835P1200X	Pharmacotherapy Pharmacist	11420	OK

General Provider Information

NPI Number	:	1164425716
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VALERIE RENEE PENNINGTON PHARM.D.

Provider Business Mailing Address
First Line	:	906 NW 16TH ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73106-6404
Country	:	US
Telephone Number	:	405-602-1930
Fax Number	:	405-604-4134

Provider Business Practice Location Address
First Line	:	906 NW 16TH ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73106-6404
Country	:	US
Telephone Number	:	405-602-1930
Fax Number	:	405-604-4134

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

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	07/08/2007

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