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Organization
CLAREMORE IHS PHARMACY
Active
Organization
CLAREMORE IHS PHARMACY
Active
Other names
CLAREMORE IHS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
TRACIE PATTEN PHARMD (AREA PHARMACY CONSULTANT)
(405) 951-6035
Entity
Organization
Contact information
Practice address
101 S MOORE AVE, CLAREMORE, OK 74017-5047
(918) 342-6581
(918) 342-6330
Mailing address
PO BOX 95431, CLEVELAND, OH 44101-0033
(918) 342-6200
(918) 342-6436
Taxonomy
Speciality
Code
Description
License number
State
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1002319601
—
OK
05
—
100231960I
—
OK
01
—
3711062
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
01/11/2007
Last updated
06/08/2023
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