Healthcare Provider Details

I. General information

NPI: 1013340249
Provider Name (Legal Business Name): PHARMCAREOK, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2013
Last Update Date: 08/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6800 NW 39TH EXPY
BETHANY OK
73008-2513
US

IV. Provider business mailing address

PO BOX 70
HYDRO OK
73048-0070
US

V. Phone/Fax

Practice location:
  • Phone: 405-787-3939
  • Fax: 888-508-3959
Mailing address:
  • Phone: 877-505-4111
  • Fax: 877-505-4114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number14399
License Number StateOK

VIII. Authorized Official

Name: KENT ABBOTT
Title or Position: PRESIDENT CEO
Credential:
Phone: 877-505-4111