MEDICARE: M & L 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
1	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1-9076	OTHER	OK	OKLAHOMA STATE BOARD OF PHARMACY LICENSE NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265060081
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	M & L PHARMACY, LLC

Provider Business Mailing Address
First Line	:	7201 E RENO AVE STE A
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73110-4484
Country	:	US
Telephone Number	:	405-737-3451
Fax Number	:	405-733-7061

Provider Business Practice Location Address
First Line	:	7201 E RENO AVE STE A
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73110-4484
Country	:	US
Telephone Number	:	405-737-3451
Fax Number	:	405-733-7061

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	LONNIE W LANGLEY
Credential	:	PHARMD
Telephone Number	:	405-737-3451

Provider Enumeration Date	:	03/28/2020
Last Update Date	:	11/04/2021

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Directions to “M & L PHARMACY, LLC ” Practice Location

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