# STATE OF OKLAHOMA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Sulphur Veterans Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124286059
- **Authorized official:** KRIS VEITCH (IT STRATEGIST)
- **Authorized official phone:** (405) 523-4091

## Contact information

- **Practice address:** 304 FAIRLANE AVE, SULPHUR, OK 73086-6861
- **Practice address phone:** (580) 622-7500
- **Practice address fax:** (580) 622-7500
- **Mailing address:** 304 FAIRLANE AVE, SULPHUR, OK 73086-6861
- **Mailing address phone:** (580) 622-7500
- **Mailing address fax:** (580) 622-7500

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | 55-2200 | OK | Yes |

## Other

- **Enumeration date:** 05/28/2008
- **Last updated:** 07/19/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2175981 | PK | — |