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General NPI Number Information
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NPI Number | 1609273903
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Entity Type | Organization
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Legal Business Name | TLC PHARMACY, LLC
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Dates
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Enumeration Date | 12/02/2014
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Last Update Date | 12/02/2014
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Provider Practice Location Address
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Address Line | 5510 S WESTERN AVE
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City | OKLAHOMA CITY
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State | OK
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Zip | 73109-4511
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Country | US
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Telephone | 405-412-8054
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 721622
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City | OKLAHOMA CITY
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State | OK
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Zip | 73172-1622
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Country | US
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Telephone | 405-412-8054
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | STANLEY YOUNG
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Credential |
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Telephone | 405-924-3006
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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