Healthcare Provider Details

I. General information

NPI: 1700578853
Provider Name (Legal Business Name): RITTER EXPRESS PHARMACY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2023
Last Update Date: 06/20/2023
Certification Date: 06/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

744 S MISSISSIPPI AVE
ATOKA OK
74525-3355
US

IV. Provider business mailing address

744 S MISSISSIPPI AVE
ATOKA OK
74525-3355
US

V. Phone/Fax

Practice location:
  • Phone: 580-889-0230
  • Fax: 580-889-3060
Mailing address:
  • Phone: 580-889-0230
  • Fax: 580-889-3060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: RYAN JAY RITTER
Title or Position: OWNER/MANAGER
Credential: D.PH
Phone: 580-889-0230