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General NPI Number Information
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NPI Number | 1144305269
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Entity Type | Organization
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Legal Business Name | SEMDRUG, LLC
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 12/08/2021
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Provider Practice Location Address
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Address Line | 1717 N MILT PHILLIPS AVE
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City | SEMINOLE
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State | OK
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Zip | 74868-2333
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Country | US
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Telephone | 405-382-5420
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Fax | 405-382-6146
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Provider Business Mailing Address
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Address Line | 1717 N MILT PHILLIPS AVE
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City | SEMINOLE
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State | OK
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Zip | 74868-2333
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Country | US
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Telephone | 405-382-5420
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Fax | 405-382-6146
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Authorized Official
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Title or Position | MEMBER
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Name | MR. KERRY D KINCADE
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Credential | DPH
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Telephone | 405-808-3226
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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 |
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License Number State |
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