Rediclinic LLC
Rediclinic LLC is a healthcare organization registered as Clinic/Center in Broken Arrow, OK, holding Type 2 (organization) NPI 1548309164 since 2007. The authorized official on file is Eric Fournet, Cfo.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1548309164 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Rediclinic LLC |
| Practice address | 2301 W KENOSHA ST, Broken Arrow, OK, 74012 |
| Phone | 8669350333 |
| Fax | 7139359353 |
| Enumeration date | 2007-02-06 |
| Last updated in NPPES | 2009-01-15 |
Authorized official
| Name | Eric Fournet |
|---|---|
| Title | Cfo |
| Phone | 7135809468 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | Primary | — | — |
Copy-ready billing details
Provider: Rediclinic LLC NPI: 1548309164 Taxonomy: 261Q00000X (Clinic/Center) Address: 2301 W KENOSHA ST, Broken Arrow, OK, 74012
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1043237167 | Wal-Mart Stores East Lp | Organization | Community/Retail Pharmacy | Broken Arrow, OK |
| 1942820386 | Ashley Mcmahon | Individual | Pharmacist | Broken Arrow, OK |
| 1972103745 | Cory Wallace | Individual | Pharmacist | Broken Arrow, OK |
| 1952902447 | Sandra Souvannachak | Individual | Pharmacist | Broken Arrow, OK |
| 1730765991 | Megan Thulin | Individual | Pharmacist | Broken Arrow, OK |
| 1033881693 | Sabrina Dunaway | Individual | Pharmacist | Broken Arrow, OK |
| 1902771173 | Wal-Mart Stores East , Lp | Organization | Optician | Broken Arrow, OK |
Verify this record
Cross-check NPI 1548309164 against the authoritative CMS record: view Rediclinic LLC on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
Where is Rediclinic LLC located?
How current is this record?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2009-01-15.