Organization
MERICH CORPORATION
Active
Other names
WEST END DRUG
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD CLEMMER RPH (OWNER AND PHARM)
(580) 536-1133
Entity
Organization
Contact information
Practice address
7210 NW CACHE RD, LAWTON, OK 73505-2712
(580) 536-1133
(580) 536-5945
Mailing address
7210 NW CACHE RD, LAWTON, OK 73505-2712
(580) 536-1133
(580) 536-5945
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
3-4619
OK
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100850780A
—
OK
01
—
2074867
PK
—
Enumeration date
07/12/2005
Last updated
10/20/2015
Update your record
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