NPIMap

Organization Active NPI

Utica Services Inc

Doing business as Ascension RX 1602

  • Community/Retail Pharmacy
  • Tulsa, OK
National Provider Identifier
1477632149
Registry record updated Feb 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
23688 Issued in OK
Legal business name
UTICA SERVICES INC
Doing business as
Ascension RX 1602
Professional Pharmacy
Practice address
1923 S Utica Ave
Tulsa, OK 74104-6520
Phone
(918) 748-7699
Fax
(918) 748-7696
NPI assigned
Nov 3, 2006
Last updated
Feb 28, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2025

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

Authorized official

Name
Steven Stubblefield
Title
Director, Net Revenue Management
Phone
(918) 744-3382

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 23688 OK Primary

Addresses

Primary practice location

1923 S Utica Ave
Tulsa, OK 74104-6520

Mailing address

1923 S Utica Ave
Tulsa, OK 74104-6520
Phone (918) 748-7699

Other identifiers 2

IdentifierTypeStateIssuer
100242580AMedicaidOK
2074644OtherPK

Other names 2

  • Ascension RX 1602 Doing business as
  • PROFESSIONAL PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20241104000010 OK Part B Supplier - Pharmacy 7719909316 Practice locations: Tulsa, OK
O20241105000029 OK Part B Supplier - Mass Immunization (Roster Biller Only) 7719909316 Practice locations: Tulsa, OK
O20250130001522 OK DME Supplier - Pharmacy 7719909316 Practice locations: Tulsa, OK

Laboratory certificates & supplier records

Derived by NPIMap

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

SupplierSuppliesMedicare assignment
St. John Medical Center1923 S Utica Ave, Tulsa, OK 74104-6520(918) 748-7699 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Jan 1, 2003

National Provider Directory

National Provider Directory

Member organizations 27

Organizations listed as members of this organization in the National Provider Directory.

View all 27

Locations

1819 E 19th St
Lowr
Tulsa, OK 74104
Phone (918) 744-3600

1919 S Wheeling Ave
Ste 102
Tulsa, OK 74104
Phone (918) 748-7680

1919 S Wheeling Ave
Ste 106
Tulsa, OK 74104
Phone (918) 748-7699

9330 E 41st St
Tulsa, OK 74145
Phone (918) 663-0933

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Ascension St. John Rehabilitation Hospital of Broken Arrow, an AffiliaBroken Arrow, OK, CCN 373034 Hospital 5% Or Greater Direct Ownership Interest (49%) Oct 1, 2015
Ascension St. John Rehabilitation Hospital of Owasso, an Affiliate ofOwasso, OK, CCN 373039 Hospital 5% Or Greater Direct Ownership Interest (49%) Jun 19, 2015
Jane Phillips Coffeyville Rural Health ClinicCoffeyville, KS, CCN 178934 Rural health clinic Operational/Managerial Control Jun 30, 2014

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740700800000",
    "number": "1477632149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1923 S UTICA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741046520",
            "telephone_number": "918-748-7699",
            "fax_number": "918-748-7696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1923 S UTICA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741046520",
            "telephone_number": "918-748-7699",
            "fax_number": "918-748-7696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UTICA SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-03",
        "last_updated": "2025-02-28",
        "certification_date": "2025-02-28",
        "status": "A",
        "authorized_official_last_name": "STUBBLEFIELD",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "DIRECTOR, NET REVENUE MANAGEMENT",
        "authorized_official_telephone_number": "918-744-3382"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OK",
            "license": "23688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100242580A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2074644",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ascension RX 1602",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PROFESSIONAL PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PROFESSIONAL PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.