Organization
HENRY ROBERTS EXPRESS PHARMACY LLC
Active
Other names
HENRY ROBERTS EXPRESS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
HENRY ROBERTS PHARM D (PHARMACIST OWNER)
(580) 223-5828
Entity
Organization
Contact information
Practice address
1316 12TH AVE NW, ARDMORE, OK 73401-1285
(580) 223-5828
(580) 226-3902
Mailing address
1316 12TH AVE NW, ARDMORE, OK 73401-1285
(580) 223-5828
(580) 226-3902
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
12-5653
OK
3336C0004X
Compounding Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100244950A
—
OK
05
—
100244950B
—
OK
01
—
2076065
PK
—
Enumeration date
08/09/2006
Last updated
08/15/2016
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