National Provider Identifier Database

CHICKASHA CLINIC PHARMACY LLC
Community/Retail Pharmacy

A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.


Contact Information

CHICKASHA CLINIC PHARMACY LLC
2224 W IOWA AVE
CHICKASHA, OK73018-2738
Phone: 405-224-4851
Fax: 405-222-9157
Website:
Specialty Taxonomy Code
* Community/Retail Pharmacy 3336C0003X
Durable Medical Equipment & Medical Supplies 332B00000X
Long Term Care Pharmacy 3336L0003X
Pharmacy 333600000X

* Indicates primary specialty

NPI Profile & details for CHICKASHA CLINIC PHARMACY LLC

NPI Number 1114087350
Legal business name
LBN
CHICKASHA CLINIC PHARMACY LLC
Authorized official JULIE JUSTICE - (AUTHORIZED AGENT)
Entity Organization
Organization subpart No
Enumeration date 12/11/2006
Last updated 06/08/2022 - About 4 years ago
Sole proprietor1 Not specified
Identifiers
  • OK License #: 18-5929
  • OK Medicaid: 100236490A
  • Other: 2135238 PK

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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