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Organization

HUNTER'S GRAND PHARMACY, LLC

Active
Other names
Hunter's Grand Pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
HUNTER JOE HOGAN III DPH (OPERATIONS MANAGER)
(405) 640-7545
Entity
Organization

Contact information

Practice address
6111 E SKELLY DR STE 1100, TULSA, OK 74135-6100
(918) 309-6774
(918) 309-6612
Mailing address
10120 BROADWAY EXT STE 200, OKLAHOMA CITY, OK 73114-6300
(405) 640-7545
(405) 418-2766

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
3336L0003X
Long Term Care Pharmacy
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2-9595
OK STATE BOARD OF PHARMACY LICENSE
OK
01
3732321
NCPDP
Enumeration date
12/08/2023
Last updated
12/29/2023
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