Organization
DEER CREEK PHARMACY INC
Active
Other names
DEER CREEK PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
KENT ABBOTT (PRESIDENT)
(405) 663-4111
Entity
Organization
Contact information
Practice address
510 N ARAPAHO AVE, HYDRO, OK 73048-8702
(405) 663-4111
(405) 663-4114
Mailing address
PO BOX 130, HYDRO, OK 73048-0130
(405) 663-4111
(405) 663-4114
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
20-5265
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2077111
PK
—
Enumeration date
10/25/2006
Last updated
02/20/2017
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