MEDICARE: CHASE LOTT

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	183500000X	Pharmacist	18899	OK

General Provider Information

NPI Number	:	1649133471
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHASE LOTT

Provider Business Mailing Address
First Line	:	1921 STONECIPHER DR
Second Line	:
City	:	ADA
State	:	OK
Zip	:	74820-3439
Country	:	US
Telephone Number	:	580-421-4550
Fax Number	:	580-421-6286

Provider Business Practice Location Address
First Line	:	1921 STONECIPHER DR
Second Line	:
City	:	ADA
State	:	OK
Zip	:	74820-3439
Country	:	US
Telephone Number	:	580-421-4550
Fax Number	:	580-421-6286

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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Directions to “ CHASE LOTT ” Practice Location

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