Healthcare Provider Details

I. General information

NPI: 1124955596
Provider Name (Legal Business Name): NORTHERN OKLAHOMA PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16603 W SOUTH AVE
TONKAWA OK
74653-4707
US

IV. Provider business mailing address

PO BOX 8
TONKAWA OK
74653-0008
US

V. Phone/Fax

Practice location:
  • Phone: 580-557-0085
  • Fax: 580-557-0069
Mailing address:
  • Phone: 580-557-0085
  • Fax: 580-557-0090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: MEGAN NICOLE PRESTON
Title or Position: DIRECTOR OF PHARMACY SERVICES
Credential:
Phone: 580-557-0085