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General NPI Number Information
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NPI Number | 1861510083
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Entity Type | Organization
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Legal Business Name | RALPHS DRUG & TAG AGENCY
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1301 SW 29TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73119-2301
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Country | US
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Telephone | 405-634-3317
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Fax | 405-634-3317
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Provider Business Mailing Address
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Address Line | 1301 SW 29TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73119-2301
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Country | US
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Telephone | 405-634-3317
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Fax | 405-634-3317
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Authorized Official
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Title or Position | PHARMACIST OWNER
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Name | MR. JOSEPH S DIMONICO
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Credential | DPH
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Telephone | 405-634-3317
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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 | 7139
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License Number State | OK
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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 | 11466
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License Number State | OK
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