Organization
TYLER DRUG
Active
Other names
TYLER DRUG
Organization subpart
No
Provider details
NPI number
Authorized official
HOWARD TYLER RPH (GENERAL PARTNER)
(405) 452-3203
Entity
Organization
Contact information
Practice address
105 N MAIN ST, WETUMKA, OK 74883-3028
(405) 452-3203
(405) 452-3352
Mailing address
105 N MAIN ST, WETUMKA, OK 74883-3028
(405) 452-3203
(405) 452-3352
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
40-3422
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100236560A
—
OK
01
—
2073340
PK
—
Enumeration date
11/08/2006
Last updated
03/19/2015
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