Healthcare Provider Details

I. General information

NPI: 1538149976
Provider Name (Legal Business Name): RAZOOK'S DRUG INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2006
Last Update Date: 02/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1518 W 9TH AVE
STILLWATER OK
74074-5468
US

IV. Provider business mailing address

1518 W 9TH AVE
STILLWATER OK
74074-5468
US

V. Phone/Fax

Practice location:
  • Phone: 405-377-4445
  • Fax: 405-377-4448
Mailing address:
  • Phone: 405-377-4445
  • Fax: 405-377-4448

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number8-2789
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. JACK RAZOOK
Title or Position: OWNER/PHARMACIST
Credential: DPH.
Phone: 405-377-4445