Organization
ELLIOTT PLAZA PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL ANDREW TURNER (MEMBER)
(918) 543-8777
Entity
Organization
Contact information
Practice address
510 S ELLIOTT ST, PRYOR, OK 74361-6411
(918) 825-2225
(918) 825-0972
Mailing address
510 S ELLIOTT ST, PRYOR, OK 74361-6411
(918) 825-2225
(918) 825-0972
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
30-4970
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2000050100B
—
OK
Enumeration date
03/14/2007
Last updated
08/22/2020
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