Organization
WINEGARDNER INC
Active
Other names
Eric's Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC WINEGARDNER D.PH. (PIC)
(405) 275-9640
Entity
Organization
Contact information
Practice address
3306 N KICKAPOO AVE, SHAWNEE, OK 74804-1702
(405) 275-9640
(405) 214-4490
Mailing address
3306 N KICKAPOO AVE, SHAWNEE, OK 74804-1702
(405) 275-9640
(405) 214-4490
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
10-5421
OK
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100811090A
—
OK
05
—
100811090B
—
OK
01
—
2074787
PK
—
Enumeration date
10/26/2006
Last updated
04/26/2024
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