Healthcare Provider Details

I. General information

NPI: 1316214026
Provider Name (Legal Business Name): KATHY'S PHARMACY & GIFTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/23/2011
Last Update Date: 09/04/2024
Certification Date: 09/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8054 HIGHWAY 16 STE 100
BEGGS OK
74421-3126
US

IV. Provider business mailing address

PO BOX 217
BEGGS OK
74421-0217
US

V. Phone/Fax

Practice location:
  • Phone: 918-267-4890
  • Fax: 918-267-4061
Mailing address:
  • Phone: 918-267-4890
  • Fax: 918-267-4061

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number145021
License Number StateOK

VIII. Authorized Official

Name: AMY HOUSER
Title or Position: PIC/OWNER
Credential:
Phone: 918-267-4890