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NPI Code Detail

MEDICARE: CARRIE LAW

MEDICARE: CARRIE LAW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist13053OK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
113053OTHEROKOK LICENSE

General Provider Information

NPI Number : 1720102049
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARRIE LAW
Provider Business Mailing Address
First Line : 1001 N COUNTRY CLUB RD
Second Line :
City : ADA
State : OK
Zip : 74820-2847
Country : US
Telephone Number : 580-421-4570
Fax Number : 690-421-6283
Provider Business Practice Location Address
First Line : 1438 HARDCASTLE BLVD
Second Line :
City : PURCELL
State : OK
Zip : 73080-8233
Country : US
Telephone Number : 405-527-4700
Fax Number : 580-559-0610
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2007
Last Update Date : 07/23/2007

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Directions to “ CARRIE LAW ” Practice Location

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