Organization
BESTYET HEALTHMART PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN BLAKE WILSON PHARMD (OWNER)
(405) 741-1200
Entity
Organization
Contact information
Practice address
19671 N E 23RD, HARRAH, OK 73045-9305
(405) 454-6261
(405) 454-6262
Mailing address
PO BOX 98, HARRAH, OK 73045-0098
(405) 454-6261
(405) 454-6262
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
1-3041
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-3041
PHARMACY LISCENSE
OK
05
—
100239820A
—
OK
05
—
100239820B
—
OK
01
—
1093716342
PHARMACY NPI
OK
Enumeration date
03/13/2007
Last updated
01/08/2021
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