Organization
PRUETT'S FOOD, INC.
Active
Parent organization
PRUETT'S FOOD, INC.
Other names
Uptown Pharmacy (Pruett's OKC)
Organization subpart
Yes
Provider details
NPI number
Legal business name
PRUETT'S FOOD, INC.
Authorized official
SHANNON JEWELANNA PRUETT (PHARMACY DIRECTOR)
(580) 236-2056
Entity
Organization
Contact information
Practice address
9515 N MAY AVE, THE VILLAGE, OK 73120
(405) 286-9080
(405) 286-9832
Mailing address
210 MAIN STREET, BROKEN BOW, OK 74728
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200019990J
—
OK
Enumeration date
01/31/2021
Last updated
04/12/2021
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