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Contact Information

KEN'S HEALTHMART LLC
200 S HIGHLAND AVE
CUSHING, OK74023-4117
 Phone: 918-225-5200
 Fax: 918-225-0828
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for KEN'S HEALTHMART LLC

NPI Number 1902999345
LBN Legal business name KEN'S HEALTHMART LLC
Authorized official KEN HIBBARD - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 09/30/2006
Last updated 01/13/2016 - About 10 years ago
Identifiers
OK License # 8-2834
OK Medicaid 100235560A
Other 2073600 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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