MEDICARE: BESTYET HEALTHMART PHARMACY

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	1-3041	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	1093716342	OTHER	OK	PHARMACY NPI
3	1-3041	OTHER	OK	PHARMACY LISCENSE
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669505616
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BESTYET HEALTHMART PHARMACY

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	:	405-454-6262

Provider Business Practice Location Address
First Line	:	19671 N E 23RD
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	:	03/13/2007
Last Update Date	:	01/08/2021

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Directions to “BESTYET HEALTHMART PHARMACY ” Practice Location

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