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Contact Information

NEWBERRY EXPRESS PHARMACY-CLINICAL SERVICES
801 S BROADWAY ST
MARLOW, OK73055-3433
 Phone: 580-658-3784
 Fax: 580-658-3725
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for NEWBERRY EXPRESS PHARMACY-CLINICAL SERVICES

NPI # 1275762932
LBN Legal business name NEWBERRY EXPRESS PHARMACY-CLINICAL SERVICES
Authorized official GARY NEWBERRY - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 07/02/2009
Last updated 07/31/2009 - About 17 years ago
Identifiers
OK License # 13-4170
OK Medicaid 100244800A
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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