Tahlequah Drug Company

LBN: Tahlequah Drug Company Llc
Tahlequah Drug Company is an health care organization with primary practice located at 2028 Mahaney Ave , Tahlequah OK 74464-5783. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Community/Retail Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Tahlequah Drug Company Llc can be contacted via phone (918) 431-0555, or through Gower, Shanon via phone (918) 931-9222.

Contact Information

Primary practice address
2028 Mahaney Ave Tahlequah OK 74464-5783
Phone: (918) 431-0555
Fax: (918) 431-0316
Website:
Map and Directions
Authorized official contact:
Name: Gower, Shanon
Phone: (918) 931-9222

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X
Suppliers / Long Term Care Pharmacy 3336L0003X

Profile Details

NPI number 1225020811
LBN Legal business name Tahlequah Drug Company Llc
DBA Doing business as Tahlequah Drug Company
Authorized official Gower, Shanon
Entity Organization
Organization subpart 1 No
Enumeration date Aug 18th, 2005
Last updated Apr 8th, 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 1225020811 NPPES
Oklahoma MEDICAID 200033290A
Oklahoma Other 2076569

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