Healthcare Provider Details

I. General information

NPI: 1891831400
Provider Name (Legal Business Name): MEDICINE CHEST LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 N BROADWAY ST
MARLOW OK
73055-2009
US

IV. Provider business mailing address

201 N BROADWAY ST
MARLOW OK
73055-2009
US

V. Phone/Fax

Practice location:
  • Phone: 580-658-3747
  • Fax: 580-658-6923
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number131815
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: KAREN ROGERS
Title or Position: OWNER
Credential:
Phone: 580-658-5634