Healthcare Provider Details

I. General information

NPI: 1255609855
Provider Name (Legal Business Name): HOSPICE PHARMACY PROVIDERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2011
Last Update Date: 12/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9100 N GARNETT RD STE K
OWASSO OK
74055-4467
US

IV. Provider business mailing address

9100 N GARNETT RD STE K
OWASSO OK
74055-4467
US

V. Phone/Fax

Practice location:
  • Phone: 918-272-6337
  • Fax: 866-279-4654
Mailing address:
  • Phone: 918-272-6337
  • Fax: 866-279-4654

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MS. SHERRY J CROCKETT
Title or Position: CEO/PRESIDENT
Credential:
Phone: 918-633-6229