Organization
BROADWAY CORNER DRUG
Active
Other names
BROADWAY CORNER DRUG
Organization subpart
No
Provider details
NPI number
Authorized official
RHONDA MCCOMBS (CO OWNER DR OF PHY)
(918) 427-1985
Entity
Organization
Contact information
Practice address
101 E SHAWNTEL SMITH BLVD, MULDROW, OK 74948
(918) 427-1985
(918) 427-1157
Mailing address
PO BOX 1469, MULDROW, OK 74948-1469
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
34-3763
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100242810A
—
OK
01
—
2074693
PK
—
Enumeration date
10/02/2006
Last updated
04/19/2016
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up