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Organization

OLYMPIA PHARMACY LLC

Active
Other names
OLYMPIA PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
SHAWN CRISMON DPH (PHARMACIST)
(918) 388-5713
Entity
Organization

Contact information

Practice address
6802 S OLYMPIA AVE, STE 125, TULSA, OK 74132-1823
(918) 398-6279
Mailing address
6802 S OLYMPIA AVE, STE 125, TULSA, OK 74132-1823
(918) 398-6279

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
25302
OK
3336C0004X
Compounding Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3725225
NCPDP PROVIDER IDENTIFICATION NUMBER
Enumeration date
06/16/2008
Last updated
02/20/2013
About Stedi
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