Healthcare Provider Details

I. General information

NPI: 1316030745
Provider Name (Legal Business Name): TRB DRUGS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2006
Last Update Date: 08/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3404 S YALE AVE
TULSA OK
74135-8016
US

IV. Provider business mailing address

3404 S YALE AVE
TULSA OK
74135-8016
US

V. Phone/Fax

Practice location:
  • Phone: 918-743-6623
  • Fax: 918-743-6654
Mailing address:
  • Phone: 918-743-6623
  • Fax: 918-743-6654

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number2-3183
License Number StateOK
# 4
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: SHARON HAYES
Title or Position: PHARMACY MGR
Credential: RPH
Phone: 918-743-6623