MEDICARE: MAYS DRUG STORES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy	43574	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3718220	OTHER	OK	NCPDP

General Provider Information

NPI Number	:	1003987942
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAYS DRUG STORES INC

Provider Business Mailing Address
First Line	:	2100 BROOKWOOD DR
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72202-1734
Country	:	US
Telephone Number	:	501-296-3312
Fax Number	:	501-296-3310

Provider Business Practice Location Address
First Line	:	3202 WEST OKMULGEE
Second Line	:
City	:	MUSKOGEE
State	:	OK
Zip	:	74401
Country	:	US
Telephone Number	:	918-683-2211
Fax Number	:	918-683-2264

Authorized Official
Title or Position	:	VP PHARMACY SERVICES
Name	:	DAVID T STROUD
Credential	:	RPH
Telephone Number	:	501-296-3312

Provider Enumeration Date	:	11/13/2006
Last Update Date	:	08/22/2020

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Directions to “MAYS DRUG STORES INC ” Practice Location

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