MEDICARE: OU MEDICINE 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	3336S0011X	Specialty Pharmacy

General Provider Information

NPI Number	:	1528713310
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OU MEDICINE INC.

Provider Business Mailing Address
First Line	:	800 NE 10TH ST # 1044
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73104-5418
Country	:	US
Telephone Number	:	572-244-0032
Fax Number	:	572-244-9841

Provider Business Practice Location Address
First Line	:	800 NE 10TH ST # 1044
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73104-5418
Country	:	US
Telephone Number	:	405-271-1488
Fax Number	:	405-271-1633

Authorized Official
Title or Position	:	DIRECTOR OF RETAIL PHARMACY
Name	:	LAURA PETTY
Credential	:
Telephone Number	:	405-808-1771

Provider Enumeration Date	:	02/21/2022
Last Update Date	:	02/03/2026

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