Organization
UNITED DISCOUNT DRUG OF GUYMON, INC.
Active
Other names
United Discount Drug
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERRY DEAN MOORE D.PH (OWNER PHARMACIST)
(580) 338-8421
Entity
Organization
Contact information
Practice address
1902 N. ACADEMY STREET, GUYMON, OK 73942
(580) 338-8421
(580) 338-0721
Mailing address
PO BOX 1131, GUYMON, OK 73942-1131
(580) 338-8421
(580) 338-0721
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
43-1959
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3710022
NCPDP
OK
Enumeration date
04/09/2007
Last updated
08/22/2020
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