Organization
CHOTEAU DISCOUNT PHARMACY INC
Active
Other names
CHOTEAU DISCOUNT PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN CHASE (OWNER)
(918) 476-6455
Entity
Organization
Contact information
Practice address
214 N CHOUTEAU AVE, CHOUTEAU, OK 74337-3242
(918) 476-6455
(918) 476-6966
Mailing address
PO BOX 700, INOLA, OK 74036-0700
(918) 476-6455
(918) 476-6966
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
30-4564
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100246450A
—
OK
01
—
2076375
PK
—
Enumeration date
12/28/2006
Last updated
11/17/2016
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