Organization
OKLAHOMA STATE UNIVERSITY
Active
Parent organization
OSU UNVIVERSITY HEALTH SERVICES
Other names
OSU University Health Services Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
OSU UNVIVERSITY HEALTH SERVICES
Authorized official
MR. JACK HENNEHA (ASSOCIATE DIRECTOR)
(405) 744-7665
Entity
Organization
Contact information
Practice address
1202 W FARM RD, STILLWATER, OK 74078-2036
(405) 744-7665
(405) 744-2136
Mailing address
1202 W FARM RD, STILLWATER, OK 74078-2036
(405) 744-7025
(405) 744-2136
Taxonomy
Speciality
Code
Description
License number
State
261QS1000X
Student Health Clinic/Center
Primary
8-3015
OK
333600000X
Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100757330F
—
OK
01
—
736017987
FEDERAL TAX ID
OK
Enumeration date
12/14/2006
Last updated
01/25/2022
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