Healthcare Provider Details

I. General information

NPI: 1073525002
Provider Name (Legal Business Name): BEST LIFE RX, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 08/19/2024
Certification Date: 08/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

536 N LAWSON BLVD
CLAYTON OK
74536
US

IV. Provider business mailing address

P.O. BOX 517
CLAYTON OK
74536
US

V. Phone/Fax

Practice location:
  • Phone: 918-569-4884
  • Fax: 918-569-4660
Mailing address:
  • Phone: 918-569-4884
  • Fax: 918-569-4660

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number StateOK
# 4
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number59-7649
License Number StateOK

VIII. Authorized Official

Name: JEFFREY S. YANCHICK
Title or Position: OWNER/PHARMACIST
Credential: MPH, DPH
Phone: 918-569-4884