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General NPI Number Information
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NPI Number | 1710018015
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Entity Type | Organization
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Legal Business Name | THRIFTY PHARMACY III
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 12/18/2016
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Provider Practice Location Address
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Address Line | 230 S SANTA FE AVE
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City | EDMOND
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State | OK
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Zip | 73003-4766
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Country | US
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Telephone | 405-715-4405
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Fax | 405-715-4407
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Provider Business Mailing Address
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Address Line | 230 S SANTA FE AVE
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City | EDMOND
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State | OK
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Zip | 73003-4766
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Country | US
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Telephone | 405-715-4405
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Fax | 405-715-4407
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Authorized Official
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Title or Position | PRES
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Name | DANI LYNCH COLSTON
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Credential | DPH
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Telephone | 405-751-2852
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care 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 | 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 #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 1-5822
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License Number State | OK
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