Organization
PHARMACY @ WELLSTON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JENNIE SWEETIN-SMITH (TECHNICIAN/ASSISTANT)
(405) 356-4199
Entity
Organization
Contact information
Practice address
309 W 2ND ST, WELLSTON, OK 74881-7488
(405) 356-4199
Mailing address
PO BOX 56, WELLSTON, OK 74881-0056
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31-8331
PHARMACY LICENSE - OKLAHOMA STATE BOARD OF PHARMACY
OK
Enumeration date
01/31/2019
Last updated
01/31/2019
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