Healthcare Provider Details

I. General information

NPI: 1235752361
Provider Name (Legal Business Name): WILLIAM RICHEY PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2020
Last Update Date: 05/23/2020
Certification Date: 05/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6901 S OLYMPIA AVE
TULSA OK
74132
US

IV. Provider business mailing address

10711 S REDBUD PL
JENKS OK
74037-2679
US

V. Phone/Fax

Practice location:
  • Phone: 918-388-5713
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number13283
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: