Healthcare Provider Details

I. General information

NPI: 1639617285
Provider Name (Legal Business Name): TURNER PHARMACY OF PURCELL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2017
Last Update Date: 07/03/2020
Certification Date: 07/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 N GREEN AVE
PURCELL OK
73080-1807
US

IV. Provider business mailing address

1300 N GREEN AVE
PURCELL OK
73080-1807
US

V. Phone/Fax

Practice location:
  • Phone: 405-527-2107
  • Fax: 405-527-5399
Mailing address:
  • Phone: 405-527-2107
  • Fax: 405-527-5399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number47-7807
License Number StateOK
# 4
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JULIE JUSTICE
Title or Position: AUTHORIZED AGENT
Credential:
Phone: 405-447-3911