Organization
EDREI, LLC.
Active
Other names
ALANS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
LISA HLADIK (MEMBER/MANAGER)
(405) 372-3331
Entity
Organization
Contact information
Practice address
1721 W 6TH AVE, STILLWATER, OK 74074-4200
(405) 372-3331
(405) 372-3547
Mailing address
1721 W 6TH AVE, STILLWATER, OK 74074-4200
(405) 372-3331
(405) 372-3547
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
83581
OK
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200725050A
—
OK
01
—
2074050
PK
—
Enumeration date
09/20/2006
Last updated
12/02/2021
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