Revan Inc

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

REVAN INC

Practice address

5601 NW 72ND St Ste 142
Warr Acres, OK 73132-5924

Phone

(888) 773-8267

Fax

(888) 998-8267

NPI assigned

Apr 11, 2019

Organization subpart

No

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

Authorized official

Name

Jason Robert Revel, PHARM.D.NPI 1639347313

Title

Owner/Pharmacist in Charge

Phone

(405) 896-7978

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jason Robert Revel, PHARM.D.

  • Pharmacist
  • Warr Acres, OK
  • NPI 1639347313
  NPD Authorized official
• Carla L Lacy, PHARMD

  • Pharmacist
  • Warr Acres, OK
  • NPI 1811583008
  NPD

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

{
    "created_epoch": "1554940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767139200000",
    "number": "1396208757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5601 NW 72ND ST STE 142",
            "city": "WARR ACRES",
            "state": "OK",
            "postal_code": "731325924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 NW 72ND ST STE 142",
            "city": "WARR ACRES",
            "state": "OK",
            "postal_code": "731325924",
            "telephone_number": "888-773-8267",
            "fax_number": "888-998-8267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVAN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-11",
        "last_updated": "2025-12-31",
        "certification_date": "2025-12-31",
        "status": "A",
        "authorized_official_last_name": "REVEL",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER/PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "405-896-7978",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200841490A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Sylvester Radonski
• Randall Otto Rahill, D.D.S.
• Rediscover You
• Katherine Galgani Rensing, CPNP-PC
• Revan Health LLC
• Jason Robert Revel, PHARM.D.
• William P Reville, D.D.S.
• Timothy Paul Rothwell, D.D.S.
• Rustee Rutherford
• Adam Schroeder, PHARMD

• Pharmacy in Warr Acres, OK
• Providers in Warr Acres, OK by specialty
• Pharmacy in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.