Organization
VERITAS PROPERTIES LLC
Active
Other names
Main Street Drug
Organization subpart
No
Provider details
NPI number
Authorized official
DARREN TIDWELL (MANAGER)
(918) 465-9300
Entity
Organization
Contact information
Practice address
225 W MAIN ST STE 1, WILBURTON, OK 74578-4045
(918) 465-9300
(918) 465-9303
Mailing address
225 W MAIN ST STE 1, WILBURTON, OK 74578-4045
(918) 465-9300
(918) 465-9303
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200081170A
—
OK
Enumeration date
02/18/2019
Last updated
02/18/2019
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