Organization
FOSTER CORNER DRUG INC
Active
Other names
FOSTER CORNER DRUG INC
Organization subpart
No
Provider details
NPI number
Authorized official
TROY SIMONS PHARMD (PRESIDENT)
(405) 742-8099
Entity
Organization
Contact information
Practice address
328 N 6TH ST, PERRY, OK 73077-6607
(580) 336-2136
(580) 336-9445
Mailing address
PO BOX 89, PERRY, OK 73077-0089
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
56-1529
OK
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100232750A
—
OK
01
—
2073059
PK
—
Enumeration date
02/27/2007
Last updated
12/10/2021
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