Organization
CATOOSA PHARMACY, LLC
Active
Other names
Catoosa Family Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID KENT JOHNSON PHARMD (MANAGING MEMBER)
(918) 231-9034
Entity
Organization
Contact information
Practice address
1818 N HIGHWAY 66 STE A, CATOOSA, OK 74015-3052
(918) 739-4774
(918) 739-4778
Mailing address
13405 E 91ST ST N, OWASSO, OK 74055-2657
(918) 231-9034
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Enumeration date
05/31/2019
Last updated
06/04/2019
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