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General NPI Number Information
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NPI Number | 1164594958
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Entity Type | Organization
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Legal Business Name | PHARM SHAWNEE ACQUISITION LLC
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Dates
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Enumeration Date | 11/15/2006
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Last Update Date | 08/28/2025
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Provider Practice Location Address
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Address Line | 1006 N HARRISON AVE
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City | SHAWNEE
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State | OK
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Zip | 74801-6419
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Country | US
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Telephone | 405-273-7360
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Fax | 405-273-4384
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Provider Business Mailing Address
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Address Line | 1006 N HARRISON AVE
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City | SHAWNEE
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State | OK
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Zip | 74801-6419
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Country | US
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Telephone | 405-273-7360
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Fax | 405-273-4384
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Authorized Official
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Title or Position | OFFICER
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Name | MATTHEW FINN
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Credential |
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Telephone | 469-261-3048
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 10-6649
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License Number State | OK
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Taxonomy #3
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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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