Healthcare Provider Details

I. General information

NPI: 1609078724
Provider Name (Legal Business Name): JAMES ARNEY RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 E 8TH STREET
BEAVER OK
73932-0640
US

IV. Provider business mailing address

PO BOX 1015
MOORELAND OK
73852-1015
US

V. Phone/Fax

Practice location:
  • Phone: 580-625-3646
  • Fax: 580-625-3844
Mailing address:
  • Phone: 580-302-3084
  • Fax: 580-625-3844

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number13758
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: