Organization
CHEYENNE PROFESSIONAL DRUG, INC
Active
Other names
SAYRE PROFESSIONAL PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
EDDIE LAKEY PHARMD (OWNER)
(580) 374-1615
Entity
Organization
Contact information
Practice address
1002 NE HIGHWAY 66 STE 1, SAYRE, OK 73662-9312
(580) 928-3633
(580) 928-3635
Mailing address
PO BOX 111, SAYRE, OK 73662-0111
(580) 928-3633
(580) 928-3635
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100244920A
—
OK
01
—
2073595
PK
—
Enumeration date
07/11/2006
Last updated
06/20/2019
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