Organization
SIMPLIFIED RX INC
Active
Other names
Cornwell Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY A STEWART (SECRETARY/TREASURER)
(918) 510-0648
Entity
Organization
Contact information
Practice address
102 W NOBLE AVE, GUTHRIE, OK 73044-3123
(405) 282-7800
(405) 282-2244
Mailing address
102 W NOBLE AVE, GUTHRIE, OK 73044-3123
(405) 282-7800
(405) 282-2244
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
32-8282
OK
3336C0004X
Compounding Pharmacy
32-8282
OK
3336L0003X
Long Term Care Pharmacy
32-8282
OK
3336S0011X
Specialty Pharmacy
32-8282
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
32-8282
STATE BOARD LICENSE
OK
Enumeration date
09/07/2018
Last updated
09/28/2021
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