Organization
ELGIN DISCOUNT PHARMACY INC
Active
Other names
ELGIN DISCOUNT PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MARK DEEVERS (OWNER AND PRESIDENT MNGR)
(580) 492-5007
Entity
Organization
Contact information
Practice address
7523 US HIGHWAY 277, ELGIN, OK 73538-2161
(580) 492-5007
(580) 492-5090
Mailing address
7523 US HIGHWAY 277, ELGIN, OK 73538-2161
(580) 492-5007
(580) 492-5090
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
35152
OK
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100237460A
—
OK
01
—
2073849
PK
—
Enumeration date
07/29/2006
Last updated
06/08/2015
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