Organization
DAVES HEALTHMART PHARMACY INC
Active
Other names
Dave's Healthmart Pharmacy Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
DIVYESH PATEL (CEO/PIC)
(405) 514-7419
Entity
Organization
Contact information
Practice address
329 N PORTER AVE, NORMAN, OK 73071-5838
(405) 360-8882
(405) 360-3154
Mailing address
329 N PORTER AVE, NORMAN, OK 73071-5838
(405) 360-8882
(405) 360-3154
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
75850
OK
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200418650A
—
OK
01
—
2133440
PK
—
Enumeration date
01/17/2012
Last updated
09/18/2019
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