Organization
BEAVER COUNTY MEMORIAL HOSPITAL
Active
Other names
Community Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ALISSA SCHLESSMAN (ADMINISTRATOR)
(580) 625-4551
Entity
Organization
Contact information
Practice address
212 EAST 8TH STREET, BEAVER, OK 73932
(580) 625-3646
(580) 625-3844
Mailing address
PO BOX 640, BEAVER, OK 73932-0640
(580) 625-3646
(580) 625-3844
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
693029
OK
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
693029
OK
332BX2000X
Oxygen Equipment & Supplies (DME)
693029
OK
3336C0003X
Community/Retail Pharmacy
693029
OK
3336I0012X
Institutional Pharmacy
693029
OK
3336L0003X
Long Term Care Pharmacy
693029
OK
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100700760C
—
OK
05
—
90003921830
—
OK
Enumeration date
02/06/2008
Last updated
02/14/2020
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