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Organization

ELK CITY RX INC

Active
Other names
GRANDVIEW PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
COLBY BREWSTER PHARMD (PIC)
(580) 225-5550
Entity
Organization

Contact information

Practice address
1220 W 3RD ST, ELK CITY, OK 73644-5106
(580) 225-5550
(580) 225-6658
Mailing address
PO BOX 370, ELK CITY, OK 73648-0370
(580) 225-5550
(580) 225-6658

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
35-5899
OK
3336L0003X
Long Term Care Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200126890A
OK
01
2074429
PK
Enumeration date
10/28/2005
Last updated
10/11/2019
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