Organization
CHEYENNE PROFESSIONAL DRUG, INC
Active
Parent organization
CHEYENNE PROFESSIONAL DRUG, INC
Other names
CPD Home Medical
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHEYENNE PROFESSIONAL DRUG, INC
Authorized official
MR. EDDIE TOM LAKEY I RPH (OWNER)
(580) 928-2741
Entity
Organization
Contact information
Practice address
111 N 4TH ST, SAYRE, OK 73662-2917
(580) 928-2741
(580) 928-2743
Mailing address
111 N 4TH ST, SAYRE, OK 73662-2917
(580) 928-2741
(580) 928-2743
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
761461
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100232590C
—
OK
Enumeration date
01/14/2008
Last updated
11/08/2009
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