Organization
MED-ECON DRUG INC
Active
Other names
MED-ECON DRUG
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GUY SHENEMAN (CEO AND DR OF PHCY)
(405) 786-2246
Entity
Organization
Contact information
Practice address
311 W 9TH ST, WELEETKA, OK 74880-9801
(405) 786-2246
(405) 786-2409
Mailing address
PO BOX 758, WELEETKA, OK 74880-0758
(405) 786-2246
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
515055
OK
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100236520A
—
OK
01
—
3713282
OTHER ID NUMBER
—
Enumeration date
10/23/2006
Last updated
10/07/2011
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