Organization
MISSION HOSPICE LLC
Active
Other names
PIETA PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DEANNE JACOBS DPH (PHARMACIST MANAGER)
(405) 841-3841
Entity
Organization
Contact information
Practice address
1608 NW EXPRESSWAY ST, STE B, OKLAHOMA CITY, OK 73118-1402
(405) 841-3841
(405) 841-3843
Mailing address
1608 NW EXPRESSWAY ST, STE B, OKLAHOMA CITY, OK 73118-1402
Taxonomy
Speciality
Code
Description
License number
State
3336S0011X
Specialty Pharmacy
Primary
15156
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3721013
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/22/2006
Last updated
08/22/2020
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