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General NPI Number Information
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NPI Number | 1073679171
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Entity Type | Organization
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Legal Business Name | PARKS DRUG
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Dates
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Enumeration Date | 12/31/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 330 N MAIN ST
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City | SEMINOLE
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State | OK
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Zip | 74868-3428
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Country | US
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Telephone | 405-382-3870
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Fax | 405-382-3872
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Provider Business Mailing Address
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Address Line | PO BOX 30 330 NORTH MAIN STREET
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City | SEMINOLE
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State | OK
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Zip | 74818-0030
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Country | US
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Telephone | 405-382-3870
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Fax | 405-382-3872
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Authorized Official
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Title or Position | R.PH., OWNER
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Name | MR. PHILLIP G. PARKS
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Credential | R.PH.
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Telephone | 405-382-3870
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 24562
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License Number State | OK
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