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General NPI Number Information
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NPI Number | 1497019699
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Entity Type | Organization
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Legal Business Name | OK PHARMACY
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Dates
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Enumeration Date | 07/02/2012
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Last Update Date | 07/02/2012
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Provider Practice Location Address
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Address Line | 5520 N MCCOLL RD
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City | MCALLEN
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State | TX
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Zip | 78504-2242
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Country | US
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Telephone | 956-618-0300
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Fax | 956-618-0307
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Provider Business Mailing Address
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Address Line | 122 S MAIN ST
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City | DONNA
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State | TX
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Zip | 78537-3226
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Country | US
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Telephone | 956-464-2200
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Fax | 956-464-2829
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Authorized Official
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Title or Position | OWNER/PHARMACIST
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Name | MR. SYLVANAS O ANIDU
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Credential | RPH
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Telephone | 956-464-2000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 41314
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License Number State | TX
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