Organization
BLACKWELL PHARMACY LLC
Active
Other names
Hutton Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID L GEORGE (CO-OWNER/MANAGER)
(580) 284-7896
Entity
Organization
Contact information
Practice address
1004 W DOOLIN AVE, BLACKWELL, OK 74631-1354
(580) 363-2137
(580) 363-5582
Mailing address
14101 N EASTERN AVE STE A, EDMOND, OK 73013-5860
(580) 284-7896
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200634910 A
—
OK
05
—
200634910A
—
OK
01
—
2158214
PK
—
Enumeration date
02/18/2016
Last updated
08/19/2024
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