Organization
DICUS THRIF-T-WISE PHARMACY, INC.
Active
Other names
DICUS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DAVE MCMILLIN PHARMACY (OWNER PRESIDENT)
(580) 332-8888
Entity
Organization
Contact information
Practice address
312 W 12TH ST, ADA, OK 74820-6406
(580) 332-8888
(580) 332-7965
Mailing address
312 W 12TH ST, ADA, OK 74820-6406
(580) 332-8888
(580) 332-7965
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
23948
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100232570A
—
OK
01
—
2072612
PK
—
Enumeration date
08/29/2006
Last updated
08/04/2016
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