Healthcare Provider Details

I. General information

NPI: 1619914041
Provider Name (Legal Business Name): REASORS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 02/15/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3328 E 51ST ST
TULSA OK
74135-3512
US

IV. Provider business mailing address

200 W CHOCTAW ST
TAHLEQUAH OK
74464-3808
US

V. Phone/Fax

Practice location:
  • Phone: 918-743-5782
  • Fax: 918-747-0338
Mailing address:
  • Phone: 918-947-8180
  • Fax: 918-947-8199

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 TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number2-6412
License Number StateOK
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DAVID MCGEHEE
Title or Position: DIRECTOR OF PHARMACY
Credential:
Phone: 918-947-8180