Healthcare Provider Details

I. General information

NPI: 1184717647
Provider Name (Legal Business Name): BRET LEE ARMSTRONG PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 05/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 N HIGHWAY 66
CATOOSA OK
74015
US

IV. Provider business mailing address

PO BOX 1949 2500 N HIGHWAY 66
CATOOSA OK
74015-1949
US

V. Phone/Fax

Practice location:
  • Phone: 918-266-8113
  • Fax: 918-266-8138
Mailing address:
  • Phone: 918-266-8113
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number13391
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: