Medic Pharmacy & Gifts

LBN: Shattuck Pharmacy Management Inc
Medic Pharmacy & Gifts is an health care organization with primary practice located at 522 S Main St , Shattuck OK 73858-9604. 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. Shattuck Pharmacy Management Inc can be contacted via phone (580) 938-2854, or through Johnson, Kyle via phone (580) 938-2854.

Contact Information

Primary practice address
522 S Main St Shattuck OK 73858-9604
Phone: (580) 938-2854
Fax: (580) 938-2888
Website:
Map and Directions
Authorized official contact:
Name: Johnson, Kyle Doctor of Public Health (DPH)
Phone: (580) 938-2854

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 75-5618 Oklahoma
Suppliers / Compounding Pharmacy 3336C0004X
Suppliers / Long Term Care Pharmacy 3336L0003X

Profile Details

NPI number 1720163959
LBN Legal business name Shattuck Pharmacy Management Inc
DBA Doing business as Medic Pharmacy & Gifts
Authorized official Johnson, Kyle Doctor of Public Health (DPH)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 26th, 2006
Last updated Oct 27th, 2021 - about 5 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 1720163959 NPPES
Oklahoma MEDICAID 100243730A
Oklahoma Other 2074859

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