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General NPI Number Information
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NPI Number | 1891551057
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Entity Type | Organization
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Legal Business Name | ERNIE'S PHARMACY & WELLNESS CENTER, INC.
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Dates
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Enumeration Date | 02/26/2024
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Last Update Date | 02/26/2024
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Provider Practice Location Address
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Address Line | 410 S 32ND ST
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City | MUSKOGEE
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State | OK
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Zip | 74401-5007
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Country | US
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Telephone | 918-816-1967
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Fax |
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Provider Business Mailing Address
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Address Line | 410 S 32ND ST
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City | MUSKOGEE
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State | OK
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Zip | 74401-5007
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Country | US
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Telephone | 918-816-1967
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ERNIE L. SYKORA
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Credential | PHARMACIST
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Telephone | 918-683-0611
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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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