Organization
SUSAN WELLS PHARMACY INC
Active
Other names
KEMP DRUG
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN WELLS (OWNER AND PHARMACIST)
(918) 367-3391
Entity
Organization
Contact information
Practice address
215 N MAIN ST, BRISTOW, OK 74010-2407
(918) 367-3391
(918) 367-3392
Mailing address
215 N MAIN ST, BRISTOW, OK 74010-2407
(918) 367-3391
(918) 367-3392
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
11-5063
OK
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200075350A
—
OK
01
—
2072692
PK
—
Enumeration date
06/21/2006
Last updated
09/19/2025
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