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NPI Code Detail

MEDICARE: JO'NEL ELAINE REYNOLDS PHARMD

MEDICARE: JO'NEL ELAINE REYNOLDS PHARMD
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
1183500000XPharmacist15187OK

General Provider Information

NPI Number : 1508467697
Entity Type Code : Individual
Provider Name (Legal Business Name) : JO'NEL ELAINE REYNOLDS PHARMD
Provider Business Mailing Address
First Line : 13213 BRAMPTON WAY
Second Line :
City : YUKON
State : OK
Zip : 73099-6587
Country : US
Telephone Number : 405-808-2574
Fax Number :
Provider Business Practice Location Address
First Line : 4101 N MAY AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73112-6239
Country : US
Telephone Number : 405-209-0363
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/04/2020
Last Update Date : 11/04/2020

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