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General NPI Number Information
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NPI Number | 1538977657
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Entity Type | Organization
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Legal Business Name | TULSA SAFFA LLC
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Dates
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Enumeration Date | 12/20/2024
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Last Update Date | 12/20/2024
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Provider Practice Location Address
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Address Line | 8004 S SHERIDAN RD
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City | TULSA
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State | OK
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Zip | 74133
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Country | US
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Telephone | 918-492-4242
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Fax | 918-493-6452
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Provider Business Mailing Address
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Address Line | 8004 S SHERIDAN RD
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City | TULSA
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State | OK
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Zip | 74133
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Country | US
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Telephone | 918-492-4242
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Fax | 918-493-6452
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Authorized Official
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Title or Position | CO-OWNER/PHARMACIST
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Name | JARRYD MATHEWS
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Credential | PHARMD
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Telephone | 580-916-2653
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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