Organization
OLE MINERS PHARMACY
Active
Other names
OLE MINERS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY D LINDERMAN PHARMACIST (OWNER)
(918) 673-1552
Entity
Organization
Contact information
Practice address
103 S CONNELL AVE, PICHER, OK 74360-0248
(918) 673-1552
(918) 673-2050
Mailing address
103 S CONNELL AVE, PICHER, OK 74360-1533
(918) 673-1552
(918) 673-2050
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100245160A
—
OK
01
—
100443320A
MEDICAID
KS
Enumeration date
09/20/2006
Last updated
01/28/2014
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