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Organization
HEALTHCARE PHARMACY OF OKLAHOMA INC
Active
Organization
HEALTHCARE PHARMACY OF OKLAHOMA INC
Active
Other names
Reavis Specialty Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE JUSTICE (AUTHORIZED AGENT)
(405) 447-3911
Entity
Organization
Contact information
Practice address
110 BURR AVE STE A, PAULS VALLEY, OK 73075-3848
(405) 238-2755
(405) 238-7357
Mailing address
110 BURR AVE STE A, PAULS VALLEY, OK 73075-3848
(405) 238-2755
(405) 238-7357
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0004X
Compounding Pharmacy
—
NULL
3336L0003X
Long Term Care Pharmacy
Primary
22-6367
OK
3336S0011X
Specialty Pharmacy
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2142503
PK
—
Enumeration date
10/23/2013
Last updated
11/06/2013
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