Organization
CDL CENTRAL DRUG INC
Active
Other names
Central Drug LTC
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN BAYER (PRESIDENT/PIC)
(405) 372-6120
Entity
Organization
Contact information
Practice address
722 S MAIN ST, STILLWATER, OK 74074
(405) 372-6120
(405) 372-2833
Mailing address
1220 W 12TH AVE, STILLWATER, OK 74074-4400
(405) 372-6120
(405) 372-2833
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
8-6924
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2175279
PK
—
05
—
N/A FOR THIS NCPDP
—
OK
Enumeration date
01/03/2018
Last updated
10/23/2024
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