Organization
SHAWNEE REGIONAL PHARMACY INC
Active
Other names
MCLOUD CLINIC PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREN PALMER PHARM D (RX MANAGER/CO-OWNER)
(405) 964-3956
Entity
Organization
Contact information
Practice address
704 S 8TH ST, STE B, MCLOUD, OK 74851-8633
(405) 964-3956
(405) 964-3959
Mailing address
704 S 8TH ST, STE B, MCLOUD, OK 74851-8633
(405) 964-3956
(405) 964-3959
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
10-4899
OK
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100233850B
—
OK
01
—
2076963
PK
—
Enumeration date
08/01/2006
Last updated
06/02/2015
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