Organization
SOUTHERN OKLAHOMA MENTAL HEALTH AND INSTITUTIONAL PHARMACY
Active
Other names
healthcare pharmacy of oklahoma
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JACK LEE JUSTICE DPH (OWNER)
(405) 238-7391
Entity
Organization
Contact information
Practice address
110 BURR AVE, PAULS VALLEY, OK 73075-3848
(405) 238-7391
(405) 238-7357
Mailing address
110 BURR AVE, PAULS VALLEY, OK 73075-3848
(405) 238-7391
(405) 238-7357
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
225038
OK
3336M0002X
Mail Order Pharmacy
225038
OK
3336S0011X
Specialty Pharmacy
Primary
225038
OK
Other
Enumeration date
11/10/2006
Last updated
09/11/2025
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