Healthcare Provider Details

I. General information

NPI: 1972679926
Provider Name (Legal Business Name): HUNTER'S SPECIALTY PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 01/04/2024
Certification Date: 10/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10120 BROADWAY EXT., SUITE 100
OKLAHOMA CITY OK
73114
US

IV. Provider business mailing address

10120 BROADWAY EXT STE 100
OKLAHOMA CITY OK
73114-6300
US

V. Phone/Fax

Practice location:
  • Phone: 405-418-2929
  • Fax: 405-749-0799
Mailing address:
  • Phone: 405-749-0600
  • Fax: 405-749-0799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: HUNTER J HOGAN III
Title or Position: OPERATIONS MANAGER
Credential: DPH
Phone: 405-640-7545