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Organization

ABOVE PAR PC

Active
Other names
MEDICAP PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
SUSAN HOOKER RPH (PHARMACIST OWNER)
(307) 685-6985
Entity
Organization

Contact information

Practice address
501 E LAKEWAY RD, SUITE A, GILLETTE, WY 82718-6416
(307) 685-6985
(307) 685-6988
Mailing address
PO BOX 1202, GILLETTE, WY 82717-1202
(307) 670-0464
(307) 459-6965

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
WY
3336C0003X
Community/Retail Pharmacy
Primary
5203562
WY
3336L0003X
Long Term Care Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
114706400
WY
05
114706401
WY
01
1891861902
NPI
01
5203562
STATE PHARMACY LICENSE
WY
Enumeration date
11/28/2006
Last updated
04/03/2023
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