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General NPI Number Information
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NPI Number | 1124192653
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Entity Type | Organization
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Legal Business Name | PHARMACY PROVIDERS INC
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Dates
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Enumeration Date | 11/17/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 104 E 2ND AVE STE B1
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City | OWASSO
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State | OK
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Zip | 74055-3127
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Country | US
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Telephone | 918-376-0303
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Fax | 918-272-2969
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Provider Business Mailing Address
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Address Line | 104 E 2ND AVE STE B1
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City | OWASSO
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State | OK
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Zip | 74055-3127
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ROGER THOMPSON
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Credential | DPH
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Telephone | 918-376-0303
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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 | 24519
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336H0001X
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Taxonomy Name | Home Infusion Therapy Pharmacy
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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