Organization
MEDKAN PHARMACY INC
Active
Other names
GC Drug
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB EDWARDS (OWNER)
(580) 395-3116
Entity
Organization
Contact information
Practice address
107 E CHEROKEE ST, MEDFORD, OK 73759-1209
(620) 877-7591
Mailing address
PO BOX 165, ATTICA, KS 67009-0165
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
—
—
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Enumeration date
11/16/2023
Last updated
12/26/2023
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