MEDICARE: JUSTIN LECRONE

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	183500000X	Pharmacist	21041	OK

General Provider Information

NPI Number	:	1558217372
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUSTIN LECRONE

Provider Business Mailing Address
First Line	:	3300 NW EXPWY
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-4418
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3300 NW EXPWY
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-4418
Country	:	US
Telephone Number	:	405-949-3390
Fax Number	:

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

Provider Enumeration Date	:	03/05/2026
Last Update Date	:	03/05/2026

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Directions to “ JUSTIN LECRONE ” Practice Location

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