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Contact Information

23RD STREET PHARMACY LLC
2316 NW 23RD ST
OKLAHOMA CITY, OK73107-2406
 Phone: 405-602-6442
 Fax: 405-602-6449
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Long Term Care Pharmacy

3336L0003X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for 23RD STREET PHARMACY LLC

NPI Number 1215202064
LBN Legal business name 23RD STREET PHARMACY LLC
Authorized official MICKEY PHAN - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 03/13/2012
Last updated 06/16/2016 - About 10 years ago
Identifiers
OK License # 16693
Other 2133976 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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