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Organization
BOOMER SOLUTIONS LLC
Active
Organization
BOOMER SOLUTIONS LLC
Active
Other names
Boomer Solutions
Organization subpart
No
Provider details
NPI number
Authorized official
KYLE SIMMONS PHARM D. (PHARMACY MANAGER)
(877) 774-3706
Entity
Organization
Contact information
Practice address
310 S 1ST ST, EUFAULA, OK 74432-3202
(877) 774-3706
(888) 852-2946
Mailing address
310 S 1ST ST, EUFAULA, OK 74432-3202
(877) 774-3706
(888) 852-2946
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
48-6828
OK
3336S0011X
Specialty Pharmacy
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200286150A
—
OK
01
—
2124945
PK
—
Enumeration date
03/09/2010
Last updated
12/02/2015
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