Reavis Drug
LBN: Jack Justice
Reavis Drug is an health care organization with primary practice located at 110 A Burr Ave , Pauls Valley OK 73075-1220. The organization recently has 4 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Jack Justice can be contacted via phone (405) 238-7391, or through Justice, Julie via phone (405) 447-3911.
Contact Information
Primary practice address
110 A Burr Ave
Pauls Valley OK 73075-1220
Phone: (405) 238-7391
Fax: (405) 238-7357
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 22-3755 | Oklahoma |
| Suppliers / Compounding Pharmacy | 3336C0004X | ||
| Suppliers / Long Term Care Pharmacy | 3336L0003X |
Profile Details
| NPI number | 1699772806 |
|---|---|
| LBN Legal business name | Jack Justice |
| DBA Doing business as | Reavis Drug |
| Authorized official | Justice, Julie |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jul 1st, 2005 |
| Last updated | Nov 17th, 2021 - about 3 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1699772806 | NPPES |
| Oklahoma | MEDICAID | 100235750A | |
| Oklahoma | Other | 2073053 |
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