Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Student Health |
261QS1000X | |||
Pharmacy |
333600000X | 58 | Medical Supply Company with Pharmacist |
| NPI Number | 1598827776 |
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| LBN Legal business name | OKLAHOMA STATE UNIVERSITY | ||||||||||||
| Authorized official | JACK HENNEHA - (ASSOCIATE DIRECTOR) | ||||||||||||
| Entity | Organization | ||||||||||||
| Organization subpart 1 | Yes | ||||||||||||
| Enumeration date | 12/14/2006 | ||||||||||||
| Last updated | 01/25/2022 - About 4 years ago | ||||||||||||
| Identifiers |
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