MEDICARE: BESTYET PHARMACY LLC

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
2	3336C0004X	Compounding Pharmacy
3	3336L0003X	Long Term Care Pharmacy
4	3336C0003X	Community/Retail Pharmacy	1-7754	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	2074157	OTHER	PK

General Provider Information

NPI Number	:	1093716342
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BESTYET PHARMACY LLC

Provider Business Mailing Address
First Line	:	PO BOX 98
Second Line	:
City	:	HARRAH
State	:	OK
Zip	:	73045-0098
Country	:	US
Telephone Number	:	405-454-6261
Fax Number	:	405-454-6261

Provider Business Practice Location Address
First Line	:	19671 NE 23RD ST
Second Line	:
City	:	HARRAH
State	:	OK
Zip	:	73045-9305
Country	:	US
Telephone Number	:	405-454-6261
Fax Number	:	405-454-6262

Authorized Official
Title or Position	:	OWNER
Name	:	JUSTIN BLAKE WILSON
Credential	:	PHARMD
Telephone Number	:	405-741-1200

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	11/06/2021

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Directions to “BESTYET PHARMACY LLC ” Practice Location

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