Organization
HEALTHCARE PHARMACY OF OKLAHOMA INC
Active
Other names
Reavis Specialty Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE JUSTICE (AUTHORIZED AGENT)
(405) 447-3911
Entity
Organization
Contact information
Practice address
110 BURR AVE STE A, PAULS VALLEY, OK 73075-3848
(405) 238-2755
(405) 238-7357
Mailing address
110 BURR AVE STE A, PAULS VALLEY, OK 73075-3848
(405) 238-2755
(405) 238-7357
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
22-6367
OK
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2142503
PK
—
Enumeration date
10/23/2013
Last updated
11/06/2013
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