Organization
SOONER DRUG AND GIFTS OR OKEMAH
Active
Other names
SOONER DRUG
Organization subpart
No
Provider details
NPI number
Authorized official
BERNIE WYATT (OWNER)
(918) 623-1036
Entity
Organization
Contact information
Practice address
324 W BROADWAY ST, OKEMAH, OK 74859-2608
(918) 623-1771
(918) 623-0238
Mailing address
324 W BROADWAY ST, OKEMAH, OK 74859-2608
(918) 623-1771
(918) 623-0238
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
512948
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100239620A
—
OK
01
—
2073031
PK
—
Enumeration date
12/28/2006
Last updated
05/26/2016
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