Healthcare Provider Details
I. General information
NPI: 1215448337
Provider Name (Legal Business Name): 1ST CHOICE PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/16/2017
Last Update Date: 03/17/2026
Certification Date: 03/17/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1024 NW 47TH ST STE C
OKLAHOMA CITY OK
73118-6403
US
IV. Provider business mailing address
9500 ORMSBY STATION RD STE 400
LOUISVILLE KY
40223-4076
US
V. Phone/Fax
- Phone: 405-509-2469
- Fax: 405-513-5971
- Phone: 502-760-0090
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336L0003X |
| Taxonomy | Long Term Care Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BRAD
ECKMANN
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 502-314-0146