Organization
RT FAMILY DISCOUNT PHARMACY INC.
Active
Other names
Family Discount Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DERRICK JONES (PHARMACIST)
(580) 762-6335
Entity
Organization
Contact information
Practice address
310 FAIRVIEW, PONCA CITY, OK 74601-2001
(580) 762-6335
(580) 762-4210
Mailing address
310 FAIRVIEW AVE, PONCA CITY, OK 74601-2001
(580) 762-6335
(580) 762-4210
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
6-5546
OK
3336C0004X
Compounding Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100234470A
—
OK
05
—
100234470B
—
OK
01
—
3701794
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
10/20/2006
Last updated
03/05/2025
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