Active NPI
Rex Charles Enterline, D.PH.
- Pharmacist
- Tulsa, OK
National Provider Identifier
1760767313
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 10145
- Practice address
- 3312 S Harvard Ave
Tulsa, OK 74135 - Phone
- (918) 742-1058
- NPI assigned
- Oct 14, 2011
- 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 | 10145 | OK | Primary |
Addresses
Primary practice location
3312 S Harvard Ave
Tulsa, OK 74135
Mailing address
4419 W Princeton PL
Broken Arrow, OK 74012-9126
Phone (918) 693-2426
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 |
|---|---|---|---|
| 10145 | OK | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1318550400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318550400000",
"number": "1760767313",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4419 W PRINCETON PL",
"city": "BROKEN ARROW",
"state": "OK",
"postal_code": "740129126",
"telephone_number": "918-693-2426",
"fax_number": "918-742-2216"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3312 S HARVARD AVE",
"city": "TULSA",
"state": "OK",
"postal_code": "74135",
"telephone_number": "918-742-1058"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENTERLINE",
"first_name": "REX",
"middle_name": "CHARLES",
"name_prefix": "Mr.",
"credential": "D.PH.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-10-14",
"last_updated": "2011-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OK",
"license": "10145",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Oct 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.