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NPI Code Detail

MEDICARE: MAKINZIE ODEN PHARMD

MEDICARE: MAKINZIE ODEN PHARMD
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
1183500000XPharmacist14741OK

General Provider Information

NPI Number : 1104271808
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAKINZIE ODEN PHARMD
Provider Business Mailing Address
First Line : 20413 E COUNTY ROAD 159
Second Line :
City : ALTUS
State : OK
Zip : 73521-8318
Country : US
Telephone Number : 580-370-6862
Fax Number :
Provider Business Practice Location Address
First Line : 1200 E PECAN ST
Second Line :
City : ALTUS
State : OK
Zip : 73521-6192
Country : US
Telephone Number : 580-379-5700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/30/2016
Last Update Date : 01/20/2023

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Directions to “ MAKINZIE ODEN PHARMD” Practice Location

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