Organization
GLENPOOL PHARMACY INC
Active
Other names
MEDICAP PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW MORGAN (SPECIALIST, CUSTOMER OPS SUPPORT)
(614) 652-1509
Entity
Organization
Contact information
Practice address
1601 N PEORIA AVE, TULSA, OK 74106-4463
(918) 322-3667
(918) 322-3667
Mailing address
PO BOX 887, GLENPOOL, OK 74033-0887
(918) 322-3667
(918) 322-5923
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
25496
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3726037
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
12/29/2009
Last updated
06/27/2012
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