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Contact Information

GLN OF HOLDENVILLE, INC
203 E HIGHWAY ST
HOLDENVILLE, OK74848-4011
 Phone: 405-379-3381
 Fax: 405-379-3962
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for GLN OF HOLDENVILLE, INC

NPI # 1275510471
LBN Legal business name GLN OF HOLDENVILLE, INC
Authorized official STEPHEN SUMMERS - (PHARMACIST IN CHARGE)
Entity Organization
Organization subpart 1 No
Enumeration date 12/28/2005
Last updated 01/24/2011 - About 15 years ago
Identifiers
OK License # 40-4623
OK Medicaid 200002680A
OK Other 3713650 NCPDP
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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