Organization
CHEROKEE HILLS PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICH E DANDRIDGE DPH (OWNER)
(918) 456-2531
Entity
Organization
Contact information
Practice address
1607 S MUSKOGEE AVE, STE D, TAHLEQUAH, OK 74464-5440
(918) 456-2531
(918) 456-2586
Mailing address
1607 S MUSKOGEE, STE D, TAHLEQUAH, OK 74464
(918) 456-2531
(918) 456-2586
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
12894
OK
332B00000X
Durable Medical Equipment & Medical Supplies
36-5140
OK
3336C0003X
Community/Retail Pharmacy
36-5140
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100234510
—
OK
Enumeration date
01/18/2007
Last updated
01/27/2011
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