Healthcare Provider Details

I. General information

NPI: 1861669640
Provider Name (Legal Business Name): STIGLER HEALTH AND WELLNESS CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2008
Last Update Date: 03/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1505 E MAIN ST UNIT C
STIGLER OK
74462-2914
US

IV. Provider business mailing address

1505 E MAIN ST SUITE C
STIGLER OK
74462-2913
US

V. Phone/Fax

Practice location:
  • Phone: 918-967-8321
  • Fax: 918-967-4469
Mailing address:
  • Phone: 918-967-8321
  • Fax: 918-967-4469

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number58-6626
License Number StateOK

VIII. Authorized Official

Name: EFTON GLOVER
Title or Position: PHARMACY DIRECTOR
Credential:
Phone: 918-967-8321