Organization
OKMULGEE DISCOUNT PHARMACY, LLC
Active
Other names
OKMULGEE DISCOUNT PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN JAY RITTER (OWNER)
(580) 889-3353
Entity
Organization
Contact information
Practice address
1160 S BELMONT AVE, OKMULGEE, OK 74447-6308
(918) 756-1223
(918) 756-3205
Mailing address
744 S MISSISSIPPI AVE STE A, ATOKA, OK 74525-3356
(580) 889-0230
(918) 756-3205
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
143741
OK
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100242700A
—
OK
05
—
100242700B
—
OK
01
—
2074685
PK
—
Enumeration date
09/30/2006
Last updated
02/10/2022
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