Healthcare Provider Details

I. General information

NPI: 1487672267
Provider Name (Legal Business Name): JOSEPH H HARDWICK PHARMD, DPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9322 E 41ST ST
TULSA OK
74145-3721
US

IV. Provider business mailing address

3706 S 201ST EAST AVE
BROKEN ARROW OK
74014-1738
US

V. Phone/Fax

Practice location:
  • Phone: 918-764-7244
  • Fax: 918-764-7296
Mailing address:
  • Phone: 918-764-7243
  • Fax: 918-764-7296

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number12688
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: