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General NPI Number Information
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NPI Number | 1316388408
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Entity Type | Organization
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Legal Business Name | VARIETY CARE INC
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Dates
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Enumeration Date | 07/17/2013
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Last Update Date | 11/06/2013
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Provider Practice Location Address
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Address Line | 1025 STRAKA TER
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City | OKLAHOMA CITY
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State | OK
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Zip | 73139-2544
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Country | US
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Telephone | 405-629-5281
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Fax | 405-629-5286
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Provider Business Mailing Address
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Address Line | 3000 N GRAND BLVD
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City | OKLAHOMA CITY
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State | OK
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Zip | 73107-1818
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Country | US
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Telephone | 405-632-6688
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Fax | 405-604-0708
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Authorized Official
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Title or Position | DIRECTOR OF PHARMACY
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Name | MICKEY PHAN
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Credential | PHARM D
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Telephone | 405-632-6688
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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 | 1-6360
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License Number State | OK
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