Healthcare Provider Details

I. General information

NPI: 1710063599
Provider Name (Legal Business Name): HITE DRUG INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 10/20/2021
Certification Date: 10/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

913 MANVEL AVE
CHANDLER OK
74834-3851
US

IV. Provider business mailing address

913 MANVEL AVE
CHANDLER OK
74834-3851
US

V. Phone/Fax

Practice location:
  • Phone: 405-258-1218
  • Fax: 405-258-2046
Mailing address:
  • Phone: 405-258-1218
  • Fax: 405-258-2046

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number31-5691
License Number StateOK
# 4
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: RICHARD COVINGTON
Title or Position: PHARMACIST/OWNER
Credential:
Phone: 405-258-1218