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General NPI Number Information
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NPI Number | 1952718009
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Entity Type | Organization
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Legal Business Name | BMTTH, LLC
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Dates
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Enumeration Date | 07/21/2014
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Last Update Date | 09/11/2018
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Provider Practice Location Address
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Address Line | 1028 CRISWELL DR STE 102
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City | DURANT
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State | OK
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Zip | 74701-1059
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Country | US
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Telephone | 580-920-1400
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Fax | 580-920-1451
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Provider Business Mailing Address
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Address Line | 1028 CRISWELL DR STE 102
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City | DURANT
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State | OK
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Zip | 74701-1059
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Country | US
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Telephone | 580-920-1400
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Fax | 580-920-1451
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Authorized Official
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Title or Position | OWNER
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Name | WILLIAM CHARLES COX
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Credential |
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Telephone | 580-924-0290
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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 | 275534
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License Number State | OK
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