Healthcare Provider Details

I. General information

NPI: 1134201932
Provider Name (Legal Business Name): SOONER DISCOUNT PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 03/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1811 W LINDSEY ST
NORMAN OK
73069-4101
US

IV. Provider business mailing address

1811 W LINDSEY ST
NORMAN OK
73069-4101
US

V. Phone/Fax

Practice location:
  • Phone: 405-329-6001
  • Fax: 405-329-6002
Mailing address:
  • Phone: 405-329-6001
  • Fax: 405-329-6002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number7-7634
License Number StateOK
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: CAREY SHERMAN
Title or Position: OWNER
Credential: DPH
Phone: 405-329-6001