Organization
ELLIOTT PLAZA PHARMACY LLC
Active
Other names
ELLIOTT PLAZA PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
P ANDREW TURNER PHRM (OWNER)
(918) 543-8777
Entity
Organization
Contact information
Practice address
510 S ELLIOTT ST, PRYOR, OK 74361-6421
(918) 825-2225
(918) 825-0972
Mailing address
PO BOX 700, INOLA, OK 74036-0700
(918) 825-2225
(918) 825-0972
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
306200
OK
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200050100A
—
OK
01
—
2076984
PK
—
Enumeration date
11/28/2006
Last updated
11/17/2016
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