Healthcare Provider Details

I. General information

NPI: 1821928813
Provider Name (Legal Business Name): AXIS RX PHARMACY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1151 N LYNN RIGGS BLVD
CLAREMORE OK
74017-3068
US

IV. Provider business mailing address

1151 N LYNN RIGGS BLVD
CLAREMORE OK
74017-3068
US

V. Phone/Fax

Practice location:
  • Phone: 918-273-1841
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JOSHUA CANTWELL
Title or Position: MANAGER
Credential:
Phone: 918-273-1841