=====================================================
General NPI Number Information
=====================================================
NPI Number | 1326476938
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DEANA GAYLE SWEATT PHARM.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/16/2013
-----------------------------------------------------
Last Update Date | 06/19/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1 TURTLE DR BEARSKIN HEALTH CLINIC PHARMACY
-----------------------------------------------------
City | WYANDOTTE
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 74370-2114
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 918-678-3244
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1 TURTLE DRIVE BEARSKIN HEALTH CLINIC PHARMACY
-----------------------------------------------------
City | WYANDOTTE
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 74370
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 918-678-3244
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 11437
-----------------------------------------------------
License Number State | OK
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | RPH 38863
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------