Healthcare Provider Details

I. General information

NPI: 1992634075
Provider Name (Legal Business Name): SEMINOLE PHARMACY (OK)
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17270 CIVIC ST NE
OKEECHOBEE FL
34974-2730
US

IV. Provider business mailing address

6401 SHERIDAN ST
HOLLYWOOD FL
33024-4156
US

V. Phone/Fax

Practice location:
  • Phone: 954-965-1331
  • Fax:
Mailing address:
  • Phone: 954-965-1331
  • Fax: 954-967-6789

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MONICA OBAN
Title or Position: PHARMACY DIRECTOR
Credential:
Phone: 954-965-1331