Organization
THOMAS WILSON PHARMACY INC
Active
Other names
WILSON PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN MATLOCK (OWNER/PHARMACIST/PRESIDENT)
(405) 737-3464
Entity
Organization
Contact information
Practice address
911 S AIR DEPOT BLVD, MIDWEST CITY, OK 73110-4836
(405) 737-3464
(405) 737-9554
Mailing address
911 S AIR DEPOT BLVD, MIDWEST CITY, OK 73110-4836
(405) 737-3464
(405) 737-9554
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
1-7280
OK
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100234270A
—
OK
05
—
100234270B
—
OK
01
—
2081553
PK
—
Enumeration date
09/12/2006
Last updated
10/25/2021
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