Organization
HERITAGE PHARMACY LLC
Active
Other names
HERITAGE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS SATCHELL (PHARMACIST/OWNER)
(405) 368-6805
Entity
Organization
Contact information
Practice address
1309 S MAIN ST, KINGFISHER, OK 73750-4402
(405) 375-6300
(405) 375-6340
Mailing address
PO BOX 896, KINGFISHER, OK 73750-0896
(405) 375-6300
(405) 375-6340
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
54-5587
OK
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100235150A
—
OK
01
—
2126196
PK
—
Enumeration date
08/12/2010
Last updated
01/14/2015
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