Healthcare Provider Details

I. General information

NPI: 1598204877
Provider Name (Legal Business Name): MCLOUD PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2017
Last Update Date: 05/22/2025
Certification Date: 05/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

704 S 8TH ST STE B
MCLOUD OK
74851-8633
US

IV. Provider business mailing address

704 S 8TH ST STE B
MCLOUD OK
74851-8633
US

V. Phone/Fax

Practice location:
  • Phone: 405-964-3956
  • Fax: 405-964-3959
Mailing address:
  • Phone: 405-964-3956
  • Fax: 405-964-3959

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number10-7799
License Number StateOK

VIII. Authorized Official

Name: WILLIAM EARL OSBORN
Title or Position: VP
Credential:
Phone: 918-542-4444