Healthcare Provider Details

I. General information

NPI: 1396753786
Provider Name (Legal Business Name): STEINHEIL PHARMACY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 04/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

418 W CHEROKEE ST
WAGONER OK
74467-4608
US

IV. Provider business mailing address

418 W CHEROKEE ST
WAGONER OK
74467-4608
US

V. Phone/Fax

Practice location:
  • Phone: 918-485-2722
  • Fax: 918-485-1702
Mailing address:
  • Phone: 918-485-2722
  • Fax: 918-485-1702

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number387589
License Number StateOK
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: RICHARD N STEINHEIL
Title or Position: PRESIDENT
Credential:
Phone: 918-485-2722