MEDICARE: OP PHARMACY 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	3336C0004X	Compounding Pharmacy
2	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1-6391	OTHER	OK	BOARD OF PHARMACY

General Provider Information

NPI Number	:	1164588430
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OP PHARMACY LLC

Provider Business Mailing Address
First Line	:	805 N WHITTINGTON PKWY STE 400
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40222-7101
Country	:	US
Telephone Number	:	502-627-7100
Fax Number	:	855-217-7498

Provider Business Practice Location Address
First Line	:	6125 W RENO AVE
Second Line	:	SUITE 750
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73127-6539
Country	:	US
Telephone Number	:	405-494-7811
Fax Number	:	405-494-7812

Authorized Official
Title or Position	:	SECRETARY
Name	:	ALLISON L. BROWN
Credential	:
Telephone Number	:	502-630-7429

Provider Enumeration Date	:	12/29/2006
Last Update Date	:	02/13/2024

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Directions to “OP PHARMACY LLC ” Practice Location

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