MEDICARE: YALE DRUG, 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		OK

General Provider Information

NPI Number	:	1114089760
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YALE DRUG, INC

Provider Business Mailing Address
First Line	:	121 N MAIN ST
Second Line	:
City	:	YALE
State	:	OK
Zip	:	74085-2507
Country	:	US
Telephone Number	:	918-387-4183
Fax Number	:	918-387-3200

Provider Business Practice Location Address
First Line	:	121 N MAIN ST
Second Line	:
City	:	YALE
State	:	OK
Zip	:	74085-2507
Country	:	US
Telephone Number	:	918-387-4183
Fax Number	:	918-387-3200

Authorized Official
Title or Position	:	PHARMACIST AND OWNER
Name	:	MR. TROY ALLEN SIMONS
Credential	:	R.PH
Telephone Number	:	918-387-4183

Provider Enumeration Date	:	12/13/2006
Last Update Date	:	08/22/2020

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Directions to “YALE DRUG, INC ” Practice Location

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