Organization
PHILLIP W & PHYLLIS J MELTON
Active
Other names
APACHE DRUG
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP MELTON RPH (OWNER)
(405) 247-3081
Entity
Organization
Contact information
Practice address
118 E EVANS, APACHE, OK 73006-9802
(580) 588-3639
(580) 588-3638
Mailing address
PO BOX 315, APACHE, OK 73006-0315
(580) 588-3639
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
203327
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100804450C
—
OK
01
—
2074309
PK
—
05
—
90003923018
—
OK
Enumeration date
10/23/2006
Last updated
01/18/2017
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