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General NPI Number Information
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NPI Number | 1346920790
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Entity Type | Organization
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Legal Business Name | EQUITY PHARMACY INC
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Dates
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Enumeration Date | 07/20/2023
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Last Update Date | 08/05/2024
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Provider Practice Location Address
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Address Line | 1822 E 15TH ST STE C
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City | TULSA
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State | OK
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Zip | 74104-4647
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Country | US
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Telephone | 918-982-6229
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Fax | 918-884-7843
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Provider Business Mailing Address
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Address Line | 1822 E 15TH ST STE C
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City | TULSA
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State | OK
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Zip | 74104-4647
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Country | US
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Telephone | 918-982-6229
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Fax | 918-884-7843
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Authorized Official
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Title or Position | OWNER
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Name | VALIMOHAMMED PANARA
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Credential |
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Telephone | 918-982-6229
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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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