Organization Active NPI

Up RX - LLC

  • Community/Retail Pharmacy
  • Tulsa, OK
National Provider Identifier
1487350260
Registry record updated Mar 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
UP RX - LLC
Practice address
11240 E 17TH PL
Tulsa, OK 74128
Phone
(918) 398-5588
Fax
(833) 311-2979
NPI assigned
Feb 3, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2024

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

Authorized official

Name
Dr. Jason Hart, PHARMDNPI 1356621825
Title
Managing Member
Phone
(918) 398-5588

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

11240 E 17TH PL
Tulsa, OK 74128

Mailing address

11240 E 17TH PL
Tulsa, OK 74128-5601
Phone (918) 398-5588

Other identifiers 1

IdentifierTypeStateIssuer
201204170AMedicaidOK

Other names 1

  • Unidos Pharmacy of Tulsa Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231031003226 OK Part B Supplier - Pharmacy 1052767779 Practice locations: Tulsa, OK

National Provider Directory

National Provider Directory

Locations

11240 E 17th Pl
Tulsa, OK 74128
Phone (918) 398-5588

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1675382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709596800000",
    "number": "1487350260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11240 E 17TH PL",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741285601",
            "telephone_number": "918-398-5588",
            "fax_number": "833-311-2979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11240 E 17TH PL",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "74128",
            "telephone_number": "918-398-5588",
            "fax_number": "833-311-2979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UP RX - LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-03",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A",
        "authorized_official_last_name": "HART",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "918-398-5588",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201204170A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Unidos Pharmacy of Tulsa",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Unidos Pharmacy of Tulsa",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2024; 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.