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Organization

GLN OF CHECOTAH INC

Active
Other names
NICHOLS PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
DR. AMY L. GARRETT PHARM.D. (PHARMACY MANAGER)
(918) 473-2304
Entity
Organization

Contact information

Practice address
207 N BROADWAY ST, CHECOTAH, OK 74426-2431
(918) 473-2304
(918) 473-6133
Mailing address
207 N BROADWAY ST, CHECOTAH, OK 74426-2431
(918) 473-2304
(918) 473-6133

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
3336C0003X
Community/Retail Pharmacy
Primary
483935
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100243600A
OK
Enumeration date
10/04/2006
Last updated
03/15/2011
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