MEDICARE: SPOON DRUGS 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	332B00000X	Durable Medical Equipment & Medical Supplies
2	333600000X	Pharmacy
3	3336C0004X	Compounding Pharmacy
4	3336L0003X	Long Term Care Pharmacy
5	3336C0003X	Community/Retail Pharmacy	2-2298	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2073684	OTHER		PK

General Provider Information

NPI Number	:	1083793756
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPOON DRUGS INC

Provider Business Mailing Address
First Line	:	540 PLAZA CT
Second Line	:
City	:	SAND SPRINGS
State	:	OK
Zip	:	74063-7915
Country	:	US
Telephone Number	:	918-245-9693
Fax Number	:	918-245-5906

Provider Business Practice Location Address
First Line	:	540 PLAZA CT
Second Line	:
City	:	SAND SPRINGS
State	:	OK
Zip	:	74063-7915
Country	:	US
Telephone Number	:	918-245-9693
Fax Number	:	918-245-5906

Authorized Official
Title or Position	:	SEC/TREAS
Name	:	WILLIAM OSBORN
Credential	:
Telephone Number	:	918-542-4444

Provider Enumeration Date	:	11/03/2006
Last Update Date	:	05/23/2025

Similar Medicare Providers

1194669200 — TULSA ACCIDENT CARE CENTER LLC
Practice Location Address:

514 PLAZA CT
SAND SPRINGS, OK
74063-7915

Practice Phone: 918-888-8080
Practice Fax: 918-888-8181

1962498519 — DR. SHANE TEWIS DDS
Practice Location Address:

530 PLAZA CT
SAND SPRINGS, OK
74063-7915

Practice Phone: 918-245-8333
Practice Fax: 918-245-8338

1942296421 — MR. TIMOTHY DANIEL REGAN DDS
Practice Location Address:

530 PLAZA CT
SAND SPRINGS, OK
74063-7915

Practice Phone: 918-245-8333
Practice Fax: 918-245-8338

1790894236 — DR. BRENT CHARLES PRITCHARD
Practice Location Address:

540 PLAZA CT
SAND SPRINGS, OK
74063-7915

Practice Phone: 918-245-9693
Practice Fax: 918-245-5906

1891804035 — JIM C PRITCHARD
Practice Location Address:

540 PLAZA CT
SAND SPRINGS, OK
74063-7915

Practice Phone: 918-245-9696
Practice Fax: 918-245-5906

1346350576 — MR. MICHAEL LEE VAUGHT DPH
Practice Location Address:

540 PLAZA CT
SAND SPRINGS, OK
74063-7915

Practice Phone: 918-245-9693
Practice Fax: 918-245-5906

Directions to “SPOON DRUGS INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.