Healthcare Provider Details
I. General information
NPI: 1902985047
Provider Name (Legal Business Name): MAYS DRUG STORES INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/02/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
626 W NEW ORLEANS ST
BROKEN ARROW OK
74011-2212
US
IV. Provider business mailing address
2100 BROOKWOOD DR
LITTLE ROCK AR
72202-1734
US
V. Phone/Fax
- Phone: 918-455-1087
- Fax: 918-451-0722
- Phone: 501-296-3312
- Fax: 501-296-3310
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | 23448 |
| License Number State | OK |
VIII. Authorized Official
Name:
DAVID
T
STROUD
Title or Position: VP PHARMACY SERVICES
Credential: RPH
Phone: 501-296-3312