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Organization

PRAGUE GROCERY, LLC

Active
Parent organization
PRAGUE GROCERY, LLC
Other names
Beachler's Pharmacy, V & B Pharmacy
Organization subpart
Yes

Provider details

NPI number
Legal business name
PRAGUE GROCERY, LLC
Authorized official
MELINDA MAY FISHER (PHARMACY MANAGER)
(405) 567-4000
Entity
Organization

Contact information

Practice address
1000 W MAIN, 3301 NBU, PRAGUE, OK 74864
(405) 567-4000
(405) 567-4883
Mailing address
1000 W MAIN, 3301 NBU, PRAGUE, OK 74864
(405) 567-4000
(405) 567-4883

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
312129
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100238090A
OK
Enumeration date
10/13/2006
Last updated
08/11/2022
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