Organization
MCCORTNEY DRUG INC
Active
Other names
MCCORTNEYS FAMILY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
BROCK HARRIS (VICE PRESIDENT)
(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
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
23-5978
OK
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100238510A
—
OK
01
—
2073507
PK
—
Enumeration date
10/26/2006
Last updated
01/13/2015
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