Organization
ST. ANTHONY SHAWNEE HOSPITAL, INC.
Active
Other names
SSM Health Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
SHASTA R MANUEL (KEG VP FINANCE-OKLAHOMA/MM)
(405) 272-7282
Entity
Organization
Contact information
Practice address
3210 KETHLEY RD., SHAWNEE, OK 74804-9625
(405) 273-9417
Mailing address
3210 KETHLEY RD., SHAWNEE, OK 74804-9625
(405) 273-9417
(405) 273-8849
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200697170B
—
OK
Enumeration date
08/16/2024
Last updated
08/16/2024
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