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Organization

THE SCRIPT SHOP INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JAMES COLVIN KELLEY D.PH. (PRESIDENT PHARMACIST)
(580) 925-2106
Entity
Organization

Contact information

Practice address
207 N BROADWAY ST, KONAWA, OK 74849-2234
(580) 925-3201
(580) 925-3729
Mailing address
207 N BROADWAY ST, KONAWA, OK 74849-2234
(580) 925-3201
(580) 925-3729

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
244253
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
244253
STATE LICENSE
OK
01
3711923
NCPDP
OK
Enumeration date
03/02/2007
Last updated
03/07/2023
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