Healthcare Provider Details

I. General information

NPI: 1346155801
Provider Name (Legal Business Name): STILLWATER MEDICAL CENTER AUTHORITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
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: 405-814-4443
  • Fax:
Mailing address:
  • Phone: 405-814-4443
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DENISE ADRIENNE WEBBER
Title or Position: CEO
Credential:
Phone: 405-742-5230