Healthcare Provider Details

I. General information

NPI: 1235455791
Provider Name (Legal Business Name): CATOOSA FAMILY PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2010
Last Update Date: 09/19/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1818 N HIGHWAY 66 STE A
CATOOSA OK
74015-3052
US

IV. Provider business mailing address

PO BOX 700
INOLA OK
74036-0700
US

V. Phone/Fax

Practice location:
  • Phone: 918-739-4774
  • Fax: 918-739-4778
Mailing address:
  • Phone: 918-543-8777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number29-8006
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ANDREW TURNER
Title or Position: MEMBER / PHARMACIST
Credential:
Phone: 918-543-8777