Organization
MOORE MED CNTR CLINIC PHCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY ANDERSON (CORP DIR OF PHCY AND MATERIALS)
(405) 917-0315
Entity
Organization
Contact information
Practice address
700 S TELEPHONE RD, MOORE, OK 73160-2502
(405) 917-0315
(405) 917-0321
Mailing address
700 S TELEPHONE RD, MOORE, OK 73160-2502
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
75069
OK
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
Primary
—
—
3336L0003X
Long Term Care Pharmacy
—
—
3336M0002X
Mail Order Pharmacy
—
—
3336M0003X
Managed Care Organization Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3724552
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/30/2006
Last updated
09/11/2025
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