Organization
LK GOODSON INC
Active
Other names
CITY DRUG OF COWETA
Organization subpart
No
Provider details
NPI number
Authorized official
LANCE GOODSON (OWNER)
(918) 486-2193
Entity
Organization
Contact information
Practice address
114 N BROADWAY, COWETA, OK 74429-2600
(918) 486-2193
(918) 486-5313
Mailing address
114 N BROADWAY, COWETA, OK 74429-2600
(918) 486-2193
(918) 486-5313
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
38-5215
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200119480A
—
OK
01
—
2072714
PK
—
Enumeration date
06/23/2006
Last updated
09/19/2025
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