Provider Demographics
NPI:1487758447
Name:TAYLOR DRUG OPERATING SERVICES INC
Entity type:Organization
Organization Name:TAYLOR DRUG OPERATING SERVICES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FRED
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:620-442-3500
Mailing Address - Street 1:11317 S WESTERN AVE
Mailing Address - Street 2:STE 200
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73170-5849
Mailing Address - Country:US
Mailing Address - Phone:405-616-1941
Mailing Address - Fax:405-616-1946
Practice Address - Street 1:11317 S WESTERN AVE
Practice Address - Street 2:STE 200
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73170-5849
Practice Address - Country:US
Practice Address - Phone:405-616-1941
Practice Address - Fax:405-616-1946
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-12
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK7-63743336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100247440BMedicaid
OK100247440AMedicaid
2076452OtherPK
0381440002Medicare NSC