Organization
SEMDRUG, LLC
Active
Other names
SEMINOLE DRUG INC, SEMINOLE DRUG
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KERRY D KINCADE DPH (MEMBER)
(405) 808-3226
Entity
Organization
Contact information
Practice address
1717 N MILT PHILLIPS AVE, SEMINOLE, OK 74868-2333
(405) 382-5420
(405) 382-6146
Mailing address
1717 N MILT PHILLIPS AVE, SEMINOLE, OK 74868-2333
(405) 382-5420
(405) 382-6146
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100235950A
—
OK
01
—
2073457
PK
—
Enumeration date
10/26/2006
Last updated
12/08/2021
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