Healthcare Provider Details

I. General information

NPI: 1255384426
Provider Name (Legal Business Name): OU MEDICINE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 02/03/2026
Certification Date: 02/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 NE 10TH ST STE 2A
OKLAHOMA CITY OK
73104-5417
US

IV. Provider business mailing address

825 NE 10TH ST STE 2A
OKLAHOMA CITY OK
73104-5417
US

V. Phone/Fax

Practice location:
  • Phone: 405-271-6446
  • Fax: 405-271-6447
Mailing address:
  • Phone: 572-244-0031
  • Fax: 572-244-9843

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number14553
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: LAURA PETTY
Title or Position: DIRECTOR OF RETAIL PHARMACY
Credential:
Phone: 405-808-1771