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General NPI Number Information
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NPI Number | 1720102049
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Entity Type | Individual
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Provider Name | CARRIE LAW
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Gender | Female
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 07/23/2007
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Provider Practice Location Address
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Address Line | 1438 HARDCASTLE BLVD
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City | PURCELL
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State | OK
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Zip | 73080-8233
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Country | US
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Telephone | 405-527-4700
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Fax | 580-559-0610
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Provider Business Mailing Address
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Address Line | 1001 N COUNTRY CLUB RD
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City | ADA
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State | OK
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Zip | 74820-2847
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Country | US
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Telephone | 580-421-4570
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Fax | 690-421-6283
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 13053
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License Number State | OK
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