Organization
HEADS PHARMACY INC
Active
Other names
HEADS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY GODFREY (PRESIDENT)
(918) 967-8877
Entity
Organization
Contact information
Practice address
501 NW H ST, STIGLER, OK 74462-1627
(918) 967-8877
(918) 967-8211
Mailing address
501 NW H ST, STIGLER, OK 74462-1627
(918) 967-8877
(918) 967-8211
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
581614
OK
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100236010A
—
OK
01
—
2073257
PK
—
Enumeration date
09/20/2006
Last updated
07/02/2014
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