Basic Information
| Provider Information | |||||||||
| NPI: | 1154069623 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TRIMMELL | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | LEVI | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PHARM.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1211 SE 17TH ST | ||||||||
| Address2: | |||||||||
| City: | NEWCASTLE | ||||||||
| State: | OK | ||||||||
| PostalCode: | 730656666 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4056300030 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 909 ALAMEDA ST | ||||||||
| Address2: | |||||||||
| City: | NORMAN | ||||||||
| State: | OK | ||||||||
| PostalCode: | 730715229 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4053605100 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/24/2022 | ||||||||
| LastUpdateDate: | 09/28/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/28/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 19574 | OK | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.