MEDICARE: RX CONCEPTS LLC

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	3336L0003X	Long Term Care Pharmacy
2	3336C0002X	Clinic Pharmacy
3	333600000X	Pharmacy
4	3336C0003X	Community/Retail Pharmacy	2-7788	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2136613	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124382585
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RX CONCEPTS LLC

Provider Business Mailing Address
First Line	:	7302 S YALE AVE STE 101
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74136-7027
Country	:	US
Telephone Number	:	918-392-3366
Fax Number	:	918-392-2950

Provider Business Practice Location Address
First Line	:	7302 S YALE AVE STE 101
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74136-7027
Country	:	US
Telephone Number	:	918-392-3366
Fax Number	:	918-392-2950

Authorized Official
Title or Position	:	OWNER, AO
Name	:	EDWARD OBANA
Credential	:	RPH
Telephone Number	:	918-392-3366

Provider Enumeration Date	:	07/01/2012
Last Update Date	:	02/20/2017

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Directions to “RX CONCEPTS LLC ” Practice Location

Language	Start Address	Practice Location

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