Organization
GLN OF MCALESTER, INC
Active
Other names
Country Mart Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
KATIE LEIGH STINCHCOMB PHARM.D. (PHARMACY MANAGER)
(918) 423-2980
Entity
Organization
Contact information
Practice address
601 E WYANDOTTE AVE, MCALESTER, OK 74501-5425
(918) 423-2980
(918) 423-4736
Mailing address
601 E WYANDOTTE AVE, MCALESTER, OK 74501-5425
(918) 423-2980
(918) 423-4736
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
10833
OK
183500000X
Pharmacist
Primary
13390
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100243460A
—
OK
Enumeration date
11/02/2006
Last updated
06/14/2010
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