Organization
PICKETTS CLINIC PHARMACY INC
Active
Other names
CLINIC PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID PICKETT RPH (OWNER/PHARM)
(580) 482-6464
Entity
Organization
Contact information
Practice address
205 S PARK LN, STE 110, ALTUS, OK 73521-5755
(580) 482-6464
(580) 480-3114
Mailing address
205 S PARK LN, STE 110, ALTUS, OK 73521-5755
(580) 482-6464
(580) 480-3114
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
174101
OK
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100238530A
—
OK
01
—
2073948
PK
—
Enumeration date
07/02/2006
Last updated
05/28/2019
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