Organization
MOORE DRUG STORE INC
Active
Other names
MOORE DRUG INC
Organization subpart
No
Provider details
NPI number
Authorized official
TOM HILDEBRANT (OWNER)
(580) 662-2366
Entity
Organization
Contact information
Practice address
101 W MAIN, RINGLING, OK 73456
(580) 662-2366
(580) 662-2966
Mailing address
PO BOX 566, RINGLING, OK 73456-0566
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
63-5964
OK
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100239450A
—
OK
01
—
2073235
PK
—
Enumeration date
10/23/2006
Last updated
12/09/2016
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