Organization
RANEY DRUG PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRADLEY HULEN RANEY DPH (OWNER)
(580) 208-2400
Entity
Organization
Contact information
Practice address
1106 SE WASHINGTON ST, IDABEL, OK 74745-3442
(580) 208-2400
(580) 208-2401
Mailing address
1106 SE WASHINGTON ST, IDABEL, OK 74745-3442
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
254731
OK
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
25-4731
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200015850A
—
OK
01
—
3723740
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
10/10/2006
Last updated
08/08/2014
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