Organization
PHARMOLOGY BRISTOW LLC
Active
Other names
SUPER H PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW FIN (OFFICER)
(469) 261-3048
Entity
Organization
Contact information
Practice address
201 E 7TH AVE, BRISTOW, OK 74010-2503
(918) 367-3328
(918) 367-2415
Mailing address
201 E 7TH AVE, BRISTOW, OK 74010-2503
(918) 367-3328
(918) 367-2415
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
11-5374
OK
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100236210A
—
OK
01
—
2073744
PK
—
Enumeration date
09/30/2006
Last updated
09/19/2018
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