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General NPI Number Information
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NPI Number | 1689044513
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Entity Type | Organization
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Legal Business Name | KASEY BADGETT PHARMACY SERVICES LLC
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Dates
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Enumeration Date | 10/05/2015
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Last Update Date | 10/05/2015
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Provider Practice Location Address
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Address Line | 102 STABLEGATE
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City | WEATHERFORD
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State | OK
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Zip | 73096-5159
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Country | US
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Telephone | 580-302-0334
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Fax |
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Provider Business Mailing Address
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Address Line | 102 STABLEGATE
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City | WEATHERFORD
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State | OK
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Zip | 73096-5159
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Country | US
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Telephone | 580-302-0334
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | KASEY BADGETT
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Credential | DPH
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Telephone | 580-302-0334
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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 | 12537
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License Number State | OK
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