Jerrys Pharmacy

LBN: Jerry Bennett
Jerrys Pharmacy is an health care organization with primary practice located at 221 Main Street , Mountain View OK 73062-0720. The organization recently has 5 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Jerry Bennett can be contacted via phone (580) 347-2519, or through Bennett, Jerry via phone (580) 347-2519.

Contact Information

Primary practice address
221 Main Street Mountain View OK 73062-0720
Phone: (580) 347-2519
Fax: (580) 347-2319
Website:
Map and Directions
Authorized official contact:
Name: Bennett, Jerry
Phone: (580) 347-2519

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 413679 Oklahoma
Suppliers / Compounding Pharmacy 3336C0004X
Suppliers / Long Term Care Pharmacy 3336L0003X

Profile Details

NPI number 1821173055
LBN Legal business name Jerry Bennett
DBA Doing business as Jerrys Pharmacy
Authorized official Bennett, Jerry
Entity Organization
Organization subpart 1 No
Enumeration date Oct 26th, 2006
Last updated Nov 18th, 2015 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821173055 NPPES
Oklahoma MEDICAID 100232770A
Oklahoma Other 2072969

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