Organization
COMMUNITY HEALTH CENTERS, INC.
Active
Other names
Mary Mahoney Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ISABELLA LAWSON MBA (CEO)
(405) 769-3301
Entity
Organization
Contact information
Practice address
12716 NE 36TH ST, OKLAHOMA CITY, OK 73140
(405) 769-3301
(405) 769-9685
Mailing address
PO BOX 30589, OKLAHOMA CITY, OK 73140-3589
(405) 769-3301
(405) 769-3301
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-1807
RETAIL PHARMACY PERMIT
OK
05
—
100234680A
—
OK
01
—
22105
OBN REGISTRATION NUMBER
OK
Enumeration date
12/01/2005
Last updated
06/14/2024
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