Black Drug

LBN: Black Drug Inc
Black Drug is an health care organization with primary practice located at 412 E Main St , Locust Grove OK 74352-5117. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Black Drug Inc can be contacted via phone (918) 479-5223, or through Black, Kevin via phone (918) 479-5223.

Contact Information

Primary practice address
412 E Main St Locust Grove OK 74352-5117
Phone: (918) 479-5223
Fax: (918) 479-6510
Website:
Map and Directions
Authorized official contact:
Name: Black, Kevin
Phone: (918) 479-5223

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 30-4476 Oklahoma
Suppliers / Compounding Pharmacy 3336C0004X

Profile Details

NPI number 1952452955
LBN Legal business name Black Drug Inc
DBA Doing business as Black Drug
Authorized official Black, Kevin
Entity Organization
Organization subpart 1 No
Enumeration date Jan 16th, 2007
Last updated Sep 27th, 2016 - about 9 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952452955 NPPES
Other 2081532 PK
MEDICAID 100232740A PK

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