Organization
DOUGHERTY'S PHARMACY MCALESTER, LLC
Active
Other names
The Medicine Shoppe Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
TERRENCE DEWITT (CEO)
(254) 722-7912
Entity
Organization
Contact information
Practice address
622 E WYANDOTTE AVE, MCALESTER, OK 74501-5426
(918) 426-5223
(918) 426-3630
Mailing address
622 E WYANDOTTE AVE, MCALESTER, OK 74501-5426
(918) 426-5223
(918) 426-3630
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
15-7361
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2154304
PK
—
Enumeration date
08/19/2015
Last updated
05/07/2021
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