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General NPI Number Information
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NPI Number | 1598840670
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Entity Type | Organization
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Legal Business Name | UNITED DISCOUNT PHARMACY #2
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 5420 N PORTLAND AVE
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City | OKLAHOMA CITY
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State | OK
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Zip | 73112-2072
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Country | US
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Telephone | 405-947-6828
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Fax | 405-946-3346
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Provider Business Mailing Address
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Address Line | 5420 N PORTLAND AVE
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City | OKLAHOMA CITY
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State | OK
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Zip | 73112-2072
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JIM WEAVER
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Credential |
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Telephone | 405-947-6828
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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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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 12576
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License Number State | OK
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