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NPI 1619037330

NPI 1619037330 : METHA CHONLAHAN D.PH. : NORMAN, OK

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General NPI Number Information
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    NPI Number           |    1619037330
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    Entity Type          |    Individual 
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    Provider Name        |    METHA CHONLAHAN D.PH.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    12/11/2006
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    Last Update Date     |    09/11/2025
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Provider Practice Location Address
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    Address Line         |    4009 RIPPLE AVE 
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    City                 |    NORMAN
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    State                |    OK
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    Zip                  |    73072-1913
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    Country              |    US
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    Telephone            |    405-701-0814
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    4009 RIPPLE AVE 
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    City                 |    NORMAN
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    State                |    OK
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    Zip                  |    73072-1913
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    Country              |    US
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    Telephone            |    405-701-0814
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    183500000X
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    Taxonomy Name        |    Pharmacist
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    License Number       |    12511
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    License Number State |    OK
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Taxonomy #2
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    Taxonomy Code        |    1835P1200X
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    Taxonomy Name        |    Pharmacotherapy Pharmacist
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    License Number       |    12511
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    License Number State |    OK
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Taxonomy #3
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    Taxonomy Code        |    1835G0303X
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    Taxonomy Name        |    Geriatric Pharmacist
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    License Number       |    12511
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    License Number State |    OK
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Taxonomy #4
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    Taxonomy Code        |    1835P1300X
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    Taxonomy Name        |    Psychiatric Pharmacist
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    License Number       |    12511
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    License Number State |    OK
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