MEDICARE: BROADWAY CORNER DRUG

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	3336C0003X	Community/Retail Pharmacy	34-3763	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	2074693	OTHER		PK

General Provider Information

NPI Number	:	1578656732
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BROADWAY CORNER DRUG

Provider Business Mailing Address
First Line	:	PO BOX 1469
Second Line	:
City	:	MULDROW
State	:	OK
Zip	:	74948-1469
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 E SHAWNTEL SMITH BLVD
Second Line	:
City	:	MULDROW
State	:	OK
Zip	:	74948
Country	:	US
Telephone Number	:	918-427-1985
Fax Number	:	918-427-1157

Authorized Official
Title or Position	:	CO OWNER DR OF PHY
Name	:	RHONDA MCCOMBS
Credential	:
Telephone Number	:	918-427-1985

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	04/19/2016

Similar Medicare Providers

1386634905 — DR. BENNIE FRANK CHEEK DO
Practice Location Address:

710 E SHAWNTEL SMITH BLVD , SUITE B
MULDROW, OK
74948

Practice Phone: 918-427-3294
Practice Fax: 918-427-1137

1033192646 — RHONDA MCCOMBS
Practice Location Address:

101 E SHAWNTEL SMITH BLVD
MULDROW, OK
74948-4416

Practice Phone: 918-427-1985
Practice Fax: 918-427-1157

1902860471 — MULDROW PUBLIC SCHOOL
Practice Location Address:

715 WEST SHAWNTEL SMITH BLVD.
MULDROW, OK
74948-0660

Practice Phone: 918-427-7406
Practice Fax:

1780603134 — PREMIER HOME HEALTH CARE, INC.
Practice Location Address:

1016 E. SHAWNTEL SMITH BOULEVARD , SUITE 2
MULDROW, OK
74948

Practice Phone: 918-427-1900
Practice Fax: 877-700-6210

1881777480 — BELFONTE ELEMENTARY SCHOOL
Practice Location Address:

475751 STATE HIGHWAY 101
MULDROW, OK
74948-6520

Practice Phone: 918-427-3522
Practice Fax: 918-427-1288

1447320502 — MULDROW PHARMACY INC.
Practice Location Address:

710 E SHAWNTEL SMITH BLVD
MULDROW, OK
74948-1109

Practice Phone: 918-427-3243
Practice Fax: 918-427-6678

Directions to “BROADWAY CORNER DRUG ” 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.