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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 Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
 

Long Term Care Pharmacy

3336L0003X 58 Medical Supply Company with Pharmacist
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for CHICKASHA CLINIC PHARMACY LLC

NPI # 1114087350
LBN Legal business name CHICKASHA CLINIC PHARMACY LLC
Authorized official JULIE JUSTICE - (AUTHORIZED AGENT)
Entity Organization
Organization subpart 1 No
Enumeration date 12/11/2006
Last updated 06/08/2022 - About 4 years ago
Identifiers
OK License # 18-5929
OK Medicaid 100236490A
Other 2135238 PK
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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