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Organization
HUNTER'S GRAND PHARMACY, LLC
Active
Organization
HUNTER'S GRAND PHARMACY, LLC
Active
Other names
Hunter's Grand Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
HUNTER JOE HOGAN III DPH (OPERATIONS MANAGER)
(405) 640-7545
Entity
Organization
Contact information
Practice address
6111 E SKELLY DR STE 1100, TULSA, OK 74135-6100
(918) 309-6774
(918) 309-6612
Mailing address
10120 BROADWAY EXT STE 200, OKLAHOMA CITY, OK 73114-6300
(405) 640-7545
(405) 418-2766
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
—
NULL
3336L0003X
Long Term Care Pharmacy
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2-9595
OK STATE BOARD OF PHARMACY LICENSE
OK
01
—
3732321
NCPDP
—
Enumeration date
12/08/2023
Last updated
12/29/2023
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