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Organization

BRODERICK ENTERPRISES, LLC

Active
Other names
McCortney's Family Pharmacy & Compounding Center, Vintage Drug Company
Organization subpart
No

Provider details

NPI number
Authorized official
ZACK BRODERICK PHARMD (PHARMACIST/OWER)
(580) 332-3344
Entity
Organization

Contact information

Practice address
711 E 9TH ST, ADA, OK 74820-3807
(580) 332-3344
(580) 332-3616
Mailing address
711 E 9TH ST, ADA, OK 74820-3807
(580) 332-3344
(580) 332-3616

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
23-8228
OK
3336C0004X
Compounding Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200803550A
OK
Enumeration date
08/01/2018
Last updated
10/03/2025
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