Organization
THOMAS DRUG INC
Active
Other names
SWANNS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ALEX KOURT DPH (OWNER)
(580) 623-4545
Entity
Organization
Contact information
Practice address
407 W MAIN ST, WATONGA, OK 73772-4233
(580) 623-4505
(580) 623-4627
Mailing address
407 W MAIN ST, WATONGA, OK 73772-4233
(580) 623-4505
(580) 623-4627
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
49-5139
OK
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100233960A
—
OK
01
—
2073333
PK
—
Enumeration date
08/17/2006
Last updated
04/17/2015
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