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General NPI Number Information
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NPI Number | 1518357151
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Entity Type | Organization
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Legal Business Name | SPRING CREEK PHARMACY LLC
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Dates
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Enumeration Date | 02/04/2015
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Last Update Date | 09/17/2020
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Provider Practice Location Address
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Address Line | 1218 E 9TH ST STE 1
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City | EDMOND
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State | OK
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Zip | 73034-5796
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Country | US
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Telephone | 405-285-9082
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Fax | 405-471-6256
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Provider Business Mailing Address
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Address Line | 1218 E 9TH ST STE 1
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City | EDMOND
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State | OK
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Zip | 73034-5796
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Country | US
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Telephone | 405-285-9082
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Fax | 405-471-6256
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | MACVICTOR VIET KY NGUYEN
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Credential |
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Telephone | 405-285-9082
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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 |
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License Number State |
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