MEDICARE: VARIETY CARE, INC.

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	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1497602908
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VARIETY CARE, INC.

Provider Business Mailing Address
First Line	:	3000 N GRAND BLVD
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73107-1818
Country	:	US
Telephone Number	:	405-632-6688
Fax Number	:

Provider Business Practice Location Address
First Line	:	1401 W. VANDAMENT
Second Line	:
City	:	YUKON
State	:	OK
Zip	:	73099
Country	:	US
Telephone Number	:	405-632-6688
Fax Number	:

Authorized Official
Title or Position	:	CREDENTIALING SUPERVISOR
Name	:	ALLISON KOPP
Credential	:
Telephone Number	:	405-632-6688

Provider Enumeration Date	:	03/13/2026
Last Update Date	:	03/13/2026

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Directions to “VARIETY CARE, INC. ” Practice Location

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