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General NPI Number Information
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NPI Number | 1306396205
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Entity Type | Organization
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Legal Business Name | SWIPHT PHARMACY INC
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Dates
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Enumeration Date | 10/04/2016
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Last Update Date | 10/04/2016
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Provider Practice Location Address
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Address Line | 14 S MISSION ST
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City | SAPULPA
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State | OK
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Zip | 74066-4634
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Country | US
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Telephone | 918-227-2010
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Fax | 917-227-2843
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Provider Business Mailing Address
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Address Line | 14 S MISSION ST
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City | SAPULPA
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State | OK
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Zip | 74066-4634
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Country | US
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Telephone | 918-227-2010
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Fax | 917-227-2843
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | TRAVIS WOLFF
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Credential | PHARMD
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Telephone | 917-227-2010
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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 | 11-5825
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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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