Organization
TULSA HILLS PHARMACY LLC
Active
Other names
Olympia Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWN CRISMON (PHARMACY MANAGER)
(918) 513-3234
Entity
Organization
Contact information
Practice address
6802 S OLYMPIA AVE, STE 125, TULSA, OK 74132-1823
(918) 513-3234
(918) 513-3229
Mailing address
6802 S OLYMPIA AVE, STE 125, TULSA, OK 74132-1823
(918) 513-3234
(918) 513-3229
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2-6487
OK
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200520280A
—
OK
01
—
2143185
PK
—
Enumeration date
11/13/2013
Last updated
02/20/2017
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