Organization
GRINNELL PRESCRIPTION SHOP INC
Active
Other names
GRINNELL PRESCRIPTION SHOP INC
Organization subpart
No
Provider details
NPI number
Authorized official
STEVE MILLER DPH (OWNER)
(580) 726-5613
Entity
Organization
Contact information
Practice address
304 S BROADWAY, HOBART, OK 73651-1862
(580) 726-5613
(580) 726-3511
Mailing address
PO BOX 192, HOBART, OK 73651-0192
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
413479
OK
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100236820A
—
OK
05
—
100236820B
—
OK
01
—
2072808
PK
—
Enumeration date
12/28/2006
Last updated
01/07/2022
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