Healthcare Provider Details

I. General information

NPI: 1336245927
Provider Name (Legal Business Name): STEVE ROBERT KRITTENBRINK PHARMACIST
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 WEST KANSAS AVENUE KRITTENBRINK PHARMACY
OKARCHE OK
73762-0405
US

IV. Provider business mailing address

PO BOX 405 315 W KANSAS AVENUE
OKARCHE OK
73762-0405
US

V. Phone/Fax

Practice location:
  • Phone: 405-263-4433
  • Fax: 405-263-4535
Mailing address:
  • Phone: 405-263-4433
  • Fax: 405-263-4535

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number8413
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: