Organization
OKEMAH PHARMACY LLC
Active
Other names
Okemah Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN RITTER (OWNER/MANAGER)
(580) 889-0230
Entity
Organization
Contact information
Practice address
106 S WOODY GUTHRIE ST, OKEMAH, OK 74859-4047
(918) 623-2510
(918) 623-0319
Mailing address
744 S MISSISSIPPI AVE STE A, ATOKA, OK 74525-3356
(918) 623-2510
(918) 623-0319
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200900380A
—
OK
05
—
200900380B
—
OK
Enumeration date
03/02/2020
Last updated
08/23/2024
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