Healthcare Provider Details

I. General information

NPI: 1689509986
Provider Name (Legal Business Name): AMANI ABU-IRMAILEH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8102 S YALE AVE
TULSA OK
74137-2210
US

IV. Provider business mailing address

8102 S YALE AVE
TULSA OK
74137-2210
US

V. Phone/Fax

Practice location:
  • Phone: 918-477-7882
  • Fax:
Mailing address:
  • Phone: 918-477-7882
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number21371
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: