Organization
KEYES' COMPOUNDING & SPECIALTY DRUG
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUZANNE HUTTON KEYES PHARMD (PHARMD/OWNER)
(580) 799-1499
Entity
Organization
Contact information
Practice address
1602 W 3RD ST, ELK CITY, OK 73644-5114
(580) 225-5273
(580) 303-4483
Mailing address
1602 W 3RD ST, ELK CITY, OK 73644-5114
(580) 225-5273
(580) 303-4483
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200473740B
—
OK
Enumeration date
08/15/2011
Last updated
11/03/2021
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