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Organization

SOONER PHARMACY OF DAVIS INC

Active
Other names
SOONER PHARMACY OF DAVIS
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL LEE RPH (PRESIDENT)
(580) 369-3776
Entity
Organization

Contact information

Practice address
705 E MAIN ST, DAVIS, OK 73030-1913
(580) 369-3776
(580) 369-2115
Mailing address
705 E MAIN ST, DAVIS, OK 73030-1913
(580) 369-3776
(580) 369-2115

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
55-4238
OK
3336L0003X
Long Term Care Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100238120A
OK
01
2073930
PK
Enumeration date
08/10/2006
Last updated
07/02/2014
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