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NPI Code Detail

MEDICARE: MORTON HEALTH CENTER PHARMACY

MEDICARE: MORTON HEALTH CENTER PHARMACY
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
1333600000XPharmacy22681OK

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3WCDPGOTHEROKMEDICARE

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

General Provider Information

NPI Number : 1235125741
Entity Type Code : Organization
Provider Name (Legal Business Name) : MORTON HEALTH CENTER PHARMACY
Provider Business Mailing Address
First Line : 1334 N LANSING AVE
Second Line :
City : TULSA
State : OK
Zip : 74106-5907
Country : US
Telephone Number : 918-295-6130
Fax Number : 918-295-6199
Provider Business Practice Location Address
First Line : 1334 N LANSING AVE
Second Line :
City : TULSA
State : OK
Zip : 74106-5907
Country : US
Telephone Number : 918-295-6130
Fax Number : 918-295-6199
Authorized Official
Title or Position : CFO
Name : SAUNYA MOORE
Credential :
Telephone Number : 918-295-6107
Provider Enumeration Date : 09/21/2005
Last Update Date : 07/24/2019

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Practice Location Address:
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1285636829 — RUNAKO D WHITTAKER MD
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1275528085 — MORTON COMPREHENSIVE HEALTH SERVICES, INC
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1619962248 — CLIFF TIMMONS
Practice Location Address:
1334 N LANSING AVE
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74106-5907
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Directions to “MORTON HEALTH CENTER PHARMACY ” Practice Location

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