Organization
THE APOTHECARY SHOPPE OF BA LLC
Active
Other names
THE APOTHECARY SHOPPE
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS MARTI PHARMD (PRESIDENT)
(918) 665-2003
Entity
Organization
Contact information
Practice address
510 N ELM PL, BROKEN ARROW, OK 74012-2539
(918) 449-9988
(918) 449-9989
Mailing address
6136 E 51ST ST, TULSA, OK 74135-7704
(918) 665-2003
(918) 665-8283
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
2-6501
OK
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2143682
PK
—
Enumeration date
12/18/2006
Last updated
07/11/2016
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