MEDICARE: DR. ANTONY JOHN TORTELL PHARM. D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	19422	OK

General Provider Information

NPI Number	:	1043977598
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANTONY JOHN TORTELL PHARM. D

Provider Business Mailing Address
First Line	:	2600 RENWICK AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73128-4919
Country	:	US
Telephone Number	:	405-863-1126
Fax Number	:

Provider Business Practice Location Address
First Line	:	7800 NW EXPRESSWAY
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73132-1554
Country	:	US
Telephone Number	:	405-721-7260
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/18/2021
Last Update Date	:	11/18/2021

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