Organization
TMC PHARMACY INC
Active
Other names
TMC PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
SHANON GOWER (OWNER)
(918) 931-9222
Entity
Organization
Contact information
Practice address
1500 E DOWNING ST, STE 106, TAHLEQUAH, OK 74464-3234
(918) 456-8811
(918) 456-1323
Mailing address
1500 E DOWNING ST, STE 106, TAHLEQUAH, OK 74464-3234
(918) 456-8811
(918) 456-1323
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100235590A
—
OK
01
—
2073660
PK
—
Enumeration date
10/18/2006
Last updated
04/08/2021
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