Organization
CLAREMORE IHS PHARMACY
Active
Other names
CLAREMORE IHS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
TRACIE PATTEN PHARMD (AREA PHARMACY CONSULTANT)
(405) 951-6035
Entity
Organization
Contact information
Practice address
101 S MOORE AVE, CLAREMORE, OK 74017-5047
(918) 342-6581
(918) 342-6330
Mailing address
PO BOX 95431, CLEVELAND, OH 44101-0033
(918) 342-6200
(918) 342-6436
Taxonomy
Speciality
Code
Description
License number
State
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1002319601
—
OK
05
—
100231960I
—
OK
01
—
3711062
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
01/11/2007
Last updated
06/08/2023
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