Organization
DAVENPORT HEALTH HOLDINGS LLC
Active
Other names
Cedar Springs Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JOEL P DAVENPORT PHARMD (OWNER/PHARMACIST IN CHARGE)
(405) 248-8455
Entity
Organization
Contact information
Practice address
5310 E HIGHWAY 37, TUTTLE, OK 73089
(405) 381-4425
(405) 381-4426
Mailing address
5310 E HIGHWAY 37, TUTTLE, OK 73089
(405) 381-4425
(405) 381-4426
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
18-2672
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100238340A
—
OK
01
—
2073923
PK
—
Enumeration date
10/26/2006
Last updated
08/09/2024
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