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Organization
STATE OF OKLAHOMA DEPT. OF HUMAN SERVICES
Active
Organization
STATE OF OKLAHOMA DEPT. OF HUMAN SERVICES
Active
Other names
Southern Oklahoma Resource Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM E JOHNSON (PROGRAMS MANAGER)
(405) 521-3565
Entity
Organization
Contact information
Practice address
RT 1 BOX 44A, PAULS VALLEY, OK 73075
(405) 238-6401
Mailing address
RT 1 BOX 44A, PAULS VALLEY, OK 73075
(405) 238-6401
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
NULL
Other
Enumeration date
10/07/2006
Last updated
08/22/2020
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