Healthcare Provider Details

I. General information

NPI: 1427965185
Provider Name (Legal Business Name): DAKOTA BARE PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2220 W IOWA AVE
CHICKASHA OK
73018-2700
US

IV. Provider business mailing address

PO BOX 307
MINCO OK
73059-0307
US

V. Phone/Fax

Practice location:
  • Phone: 405-779-2300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number18277
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: