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Organization

SWANNS PHARMACY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ALEX KOURT (VP)
(580) 661-3549
Entity
Organization

Contact information

Practice address
116 N MAIN ST, WATONGA, OK 73763-9401
(580) 822-3789
(580) 822-3136
Mailing address
116 N MAIN ST, PO BOX 549, WATONGA, OK 73772

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
495139
OK
3336C0003X
Community/Retail Pharmacy
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3706415
OTHER ID NUMBER-COMMERCIAL NUMBER
05
90003931912
OK
Enumeration date
01/23/2007
Last updated
09/11/2025
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  • Claims
  • Eligibility checks
  • EDI platform