Healthcare Provider Details

I. General information

NPI: 1639234057
Provider Name (Legal Business Name): ALLEN PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2006
Last Update Date: 03/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

521 E FRANKLIN AVE
WEATHERFORD OK
73096-5337
US

IV. Provider business mailing address

PO BOX 389
WEATHERFORD OK
73096-0389
US

V. Phone/Fax

Practice location:
  • Phone: 580-772-3347
  • Fax: 580-772-3350
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number281567
License Number StateOK

VIII. Authorized Official

Name: TRAVIS BAUGHMAN
Title or Position: PHARMACIST MANAGER
Credential:
Phone: 580-772-3347