Organization
STATE OF OKLAHOMA
Active
Other names
Lawton Veterans Center
Organization subpart
No
Provider details
NPI number
Authorized official
TINA WILLIAMS (COMPLIANCE DIRECTOR)
(405) 523-4000
Entity
Organization
Contact information
Practice address
501 SE FLOWER MOUND RD, LAWTON, OK 73501-6388
(580) 351-6511
(580) 351-6511
Mailing address
501 SE FLOWER MOUND RD, LAWTON, OK 73501-6388
(580) 351-6511
(580) 351-6511
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
3-4725
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2176125
PK
—
Enumeration date
05/19/2008
Last updated
07/19/2018
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