Twin R No 2 Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

1-4593 Issued in OK

Legal business name

TWIN R NO 2 INC

Doing business as

Crest RX Pharmacy

Practice address

249 N Douglas Blvd
Midwest City, OK 73130-3309

Phone

(405) 741-4411

Fax

(405) 733-7260

NPI assigned

Sep 30, 2006

Last updated

Feb 10, 2025By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Macvictor Viet Ky NguyenNPI 1457092066

Title

Manager

Phone

(405) 741-4411

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• CREST RX PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Macvictor Viet Ky Nguyen, DPH

  • Pharmacist
  • Midwest City, OK
  • NPI 1457092066
  NPD Authorized official
• John Phillip Moss, DPH

  • Pharmacist
  • Midwest City, OK
  • NPI 1902974132
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739145600000",
    "number": "1043303472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10763",
            "city": "MIDWEST CITY",
            "state": "OK",
            "postal_code": "731401763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "249 N DOUGLAS BLVD",
            "city": "MIDWEST CITY",
            "state": "OK",
            "postal_code": "731303309",
            "telephone_number": "405-741-4411",
            "fax_number": "405-733-7260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TWIN R NO 2 INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-30",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "MACVICTOR",
        "authorized_official_middle_name": "VIET KY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "405-741-4411"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OK",
            "license": "1-4593",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2072548",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100234140A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CREST RX PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jynese Trumble, DR.
• Jessica Nicole Tucker
• Megan Rae Tucker, OD
• Patrick Tucker
• Jack Arnold Tully, DPT
• Tyson Quy, M.D., Inc. (Air Depot Family Medicine)
• Ricky Don Tyson, DC
• Happy Itiomemena Ukereti, CPRSS
• Mfon Effiong Umana
• Anthony Lawrence Umoh, MD

• Community/Retail Pharmacy in Midwest City, OK
• Providers in Midwest City, OK by specialty
• Community/Retail Pharmacy in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.