Organization
PHARMACY PROVIDERS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROGER THOMPSON DPH (PRESIDENT)
(918) 376-0303
Entity
Organization
Contact information
Practice address
104 E 2ND AVE, STE B1, OWASSO, OK 74055-3127
(918) 376-0303
(918) 272-2969
Mailing address
104 E 2ND AVE, STE B1, OWASSO, OK 74055-3127
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
24519
OK
3336C0004X
Compounding Pharmacy
Primary
—
—
3336H0001X
Home Infusion Therapy Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3722394
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
11/17/2006
Last updated
09/11/2025
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