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Organization

UNITED DISCOUNT PHARMACY #2

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JIM WEAVER (OWNER)
(405) 947-6828
Entity
Organization

Contact information

Practice address
5420 N PORTLAND AVE, OKLAHOMA CITY, OK 73112-2072
(405) 947-6828
(405) 946-3346
Mailing address
5420 N PORTLAND AVE, OKLAHOMA CITY, OK 73112-2072

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
12576
OK
3336C0003X
Community/Retail Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3702227
OTHER ID NUMBER-COMMERCIAL NUMBER
05
90003917994
OK
Enumeration date
10/26/2006
Last updated
09/11/2025
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  • Eligibility checks
  • EDI platform