Organization
REVAN INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON ROBERT REVEL PHARM.D. (OWNER/PHARMACIST IN CHARGE)
(405) 896-7978
Entity
Organization
Contact information
Practice address
5601 NW 72ND ST STE 142, WARR ACRES, OK 73132-5924
(888) 773-8267
(888) 998-8267
Mailing address
5601 NW 72ND ST STE 142, WARR ACRES, OK 73132-5924
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200841490A
—
OK
Enumeration date
04/11/2019
Last updated
12/31/2025
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