Provider Demographics
NPI:1942011697
Name:OU MEDICINE INC.
Entity type:Organization
Organization Name:OU MEDICINE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN DIRECTOR OF RETAIL PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:PETTY
Authorized Official - Suffix:
Authorized Official - Credentials:DPH
Authorized Official - Phone:405-808-1771
Mailing Address - Street 1:1200 CHILDRENS AVE.
Mailing Address - Street 2:11TH FLOOR, STE 11051L
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73104
Mailing Address - Country:US
Mailing Address - Phone:405-271-1047
Mailing Address - Fax:
Practice Address - Street 1:1000 NE 13TH ST.
Practice Address - Street 2:SUITE 3840
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-7310
Practice Address - Country:US
Practice Address - Phone:405-271-4253
Practice Address - Fax:405-896-4292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-14
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy