# MEDKAN PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** GC Drug LTC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255197034
- **Authorized official:** JACOB EDWARDS (OWNER)
- **Authorized official phone:** (580) 395-3116

## Contact information

- **Practice address:** 107 E CHEROKEE ST, MEDFORD, OK 73759-1209
- **Practice address phone:** (580) 395-3116
- **Mailing address:** PO BOX 165, ATTICA, KS 67009-0165

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | — |
| 3336C0004X | Compounding Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |
| 3336S0011X | Specialty Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 02/28/2024
- **Last updated:** 02/28/2024