Active NPI
Roy Chacko George, D.PH.
- Pharmacist
- Oklahoma City, OK
National Provider Identifier
1023020153
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 12464
- Practice address
- 4913 W Reno Ave
Oklahoma City, OK 73127-6339 - Phone
- (405) 948-4900
- Fax
- (405) 948-4929
- NPI assigned
- Aug 13, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 12464 | OK | Primary |
Addresses
Primary practice location
4913 W Reno Ave
Oklahoma City, OK 73127-6339
Mailing address
1200 Camelot Dr
Yukon, OK 73099-1300
Phone (405) 350-1327
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12464 | OK | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1023020153",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 CAMELOT DR",
"city": "YUKON",
"state": "OK",
"postal_code": "730991300",
"telephone_number": "405-350-1327"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4913 W RENO AVE",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731276339",
"telephone_number": "405-948-4900",
"fax_number": "405-948-4929"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GEORGE",
"first_name": "ROY",
"middle_name": "CHACKO",
"credential": "D.PH.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OK",
"license": "12464",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.