Organization
COLLINSVILLE FAMILY PHARMACY LC
Active
Other names
COLLINSVILLE FAMILY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
COLTON B TURNBULL (PHARMACIST AND OWNER)
(918) 371-2547
Entity
Organization
Contact information
Practice address
1205 W MAIN ST STE A, COLLINSVILLE, OK 74021-3114
(918) 371-2547
(918) 371-0268
Mailing address
1205 W MAIN ST STE A, COLLINSVILLE, OK 74021-3114
(918) 371-2547
(918) 371-0268
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
26388
OK
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100807920A
—
OK
05
—
100807920B
—
OK
01
—
2081529
PK
—
Enumeration date
06/21/2006
Last updated
07/08/2020
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