Healthcare Provider Details

I. General information

NPI: 1124486030
Provider Name (Legal Business Name): VIAN DRUG COMPANY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2016
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 S THORNTON ST
VIAN OK
74962
US

IV. Provider business mailing address

PO BOX 465
VIAN OK
74962-0465
US

V. Phone/Fax

Practice location:
  • Phone: 918-773-8111
  • Fax: 918-773-5110
Mailing address:
  • Phone: 918-773-8111
  • Fax: 918-773-5110

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. JASON DANIEL CARTER
Title or Position: OWNER/CEO
Credential: PHARMD
Phone: 918-773-8111