Organization
MARIETTA PHARMACY LLC
Active
Other names
Marietta Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN JAY RITTER (OWNER)
(580) 889-3353
Entity
Organization
Contact information
Practice address
300 S HIGHWAY 77, MARIETTA, OK 73448-3447
(580) 276-5555
(580) 276-5355
Mailing address
744 S MISSISSIPPI AVE, ATOKA, OK 74525-3355
(580) 276-5555
(580) 276-5355
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
72-7286
OK
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100235740B
—
OK
05
—
100235740C
—
OK
01
—
2152842
PK
—
Enumeration date
06/30/2015
Last updated
06/20/2023
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