Healthcare Provider Details

I. General information

NPI: 1992644017
Provider Name (Legal Business Name): ALISON CUPP PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 03/25/2026
Certification Date: 03/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1921 STONECIPHER DR
ADA OK
74820-3439
US

IV. Provider business mailing address

1125 GREEN TURTLE CIR
ADA OK
74820
US

V. Phone/Fax

Practice location:
  • Phone: 580-421-2994
  • Fax: 580-272-1016
Mailing address:
  • Phone: 580-583-4677
  • Fax: 580-272-1016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number17030
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: