Organization
CENTRAL OKLAHOMA FAMILY MEDICAL CENTER INC
Active
Other names
CENTRAL OK FAMILY MED CENTER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
BLAKE WORLUND PHARMD (PIC)
(580) 925-8911
Entity
Organization
Contact information
Practice address
527 W 3RD ST, KONAWA, OK 74849-1415
(580) 925-8911
(580) 925-8920
Mailing address
PO BOX 358, KONAWA, OK 74849-0358
(580) 925-8911
(580) 925-8920
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
244685
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007371601
—
OK
01
—
2076461
PK
—
Enumeration date
10/19/2006
Last updated
11/15/2021
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