Organization
HUNTERS GREEN COUNTRY PHARMACY LLC
Active
Other names
Hunters Green Country Pharmacy LLC
Organization subpart
No
Provider details
NPI number
Authorized official
HUNTER JOE HOGAN III DPH (OPERATIONS MANAGER)
(405) 418-2929
Entity
Organization
Contact information
Practice address
110 W MARTIN LUTHER KING ST STE 2D, MUSKOGEE, OK 74401-3351
(918) 913-3652
(918) 683-2185
Mailing address
10120 BROADWAY EXT STE 200, OKLAHOMA CITY, OK 73114-6300
(405) 640-7545
(405) 418-2766
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
4-6511
OK
3336L0003X
Long Term Care Pharmacy
Primary
4-6511
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1285056846
NPI
—
05
—
200536460A
—
OK
01
—
2143834
PK
—
01
—
3727825
NCPDP
—
01
—
4-6511
STATE LICENSE OK
OK
01
—
47420
OBNDD - BUREAU OF NARCOTICS OK
OK
Enumeration date
01/15/2014
Last updated
01/27/2026
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