Organization
P & S PHARMACY INC
Active
Other names
P AND S PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MARY BOREN (OWNER PHARMACIST)
(405) 379-5431
Entity
Organization
Contact information
Practice address
820 E HIGHWAY ST, HOLDENVILLE, OK 74848-4227
(405) 379-5431
(405) 379-3474
Mailing address
PO BOX 71, HOLDENVILLE, OK 74848-0071
(405) 379-5431
(405) 379-3474
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
40-2274
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100236090A
—
OK
01
—
3712381
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
10/31/2006
Last updated
01/18/2011
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