Organization
ADA APOTHECARY PLLC
Active
Other names
Ada Apothecary
Organization subpart
No
Provider details
NPI number
Authorized official
BEVERLY SMITH (PIC)
(405) 990-0666
Entity
Organization
Contact information
Practice address
1201B ARLINGTON ST, ADA, OK 74820-4072
(580) 332-2000
(580) 332-2004
Mailing address
1201B ARLINGTON ST, ADA, OK 74820-4072
(580) 332-2000
(580) 332-2004
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
237302
OK
3336C0004X
Compounding Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2151917
PK
—
Enumeration date
08/03/2015
Last updated
06/29/2017
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