Provider Demographics
NPI:1730267774
Name:LIFEPLUS MINISTRIES, INC.
Entity type:Organization
Organization Name:LIFEPLUS MINISTRIES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-924-6048
Mailing Address - Street 1:1400 BRYAN DR STE 100
Mailing Address - Street 2:
Mailing Address - City:DURANT
Mailing Address - State:OK
Mailing Address - Zip Code:74701-2156
Mailing Address - Country:US
Mailing Address - Phone:580-924-6048
Mailing Address - Fax:580-924-0280
Practice Address - Street 1:1400 BRYAN DR STE 100
Practice Address - Street 2:
Practice Address - City:DURANT
Practice Address - State:OK
Practice Address - Zip Code:74701-2156
Practice Address - Country:US
Practice Address - Phone:580-924-6048
Practice Address - Fax:580-924-0280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK27-4345183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK3715111OtherNABP NUMBER
OK1320730001Medicare ID - Type UnspecifiedMEDICARE