Organization
GATRELL 6 ENTERPRISES LLC
Active
Other names
WEIGANTS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
GAVIN GATRELL (OWNER)
(918) 287-1158
Entity
Organization
Contact information
Practice address
714 KIHEKAH AVE, PAWHUSKA, OK 74056-3206
(918) 287-1317
(918) 287-1158
Mailing address
714 KIHEKAH AVE, PAWHUSKA, OK 74056-3206
(918) 287-1317
(918) 287-1158
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100237390A
—
OK
01
—
2073862
PK
—
Enumeration date
09/30/2006
Last updated
12/06/2021
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