Healthcare Provider Details

I. General information

NPI: 1194650630
Provider Name (Legal Business Name): 1ST CHOICE PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4720 E 51ST ST STE B
TULSA OK
74135-3704
US

IV. Provider business mailing address

9500 ORMSBY STATION RD STE 400
LOUISVILLE KY
40223-4076
US

V. Phone/Fax

Practice location:
  • Phone: 918-796-3310
  • Fax: 833-947-7399
Mailing address:
  • Phone: 502-760-0090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: FARA TIPPIT
Title or Position: PHARMACY ADMINISTRATIVE SPECIALIST
Credential:
Phone: 502-760-0089