Healthcare Provider Details
I. General information
NPI: 1376728626
Provider Name (Legal Business Name): PHARMACY OPERATIONS INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/07/2008
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1400 BRYAN DR STE 102
DURANT OK
74701-2156
US
IV. Provider business mailing address
1 RIDER TRAIL PLAZA DR SUITE 300
EARTH CITY MO
63045-1313
US
V. Phone/Fax
- Phone: 580-924-6048
- Fax: 580-924-0913
- Phone: 314-993-6000
- Fax: 314-872-5558
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | 275289 |
| License Number State | OK |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DENA
FERMAN
Title or Position: THIRD PARTY PLAN COORDINATOR
Credential:
Phone: 314-993-6000