City Drug

LBN: City Drug Of Idabel Inc
City Drug is an health care organization with primary practice located at 12 S Central Ave , Idabel OK 74745-4626. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. City Drug Of Idabel Inc can be contacted via phone (580) 286-3235, or through Nicholson, Jerry via phone (580) 286-3235.

Contact Information

Primary practice address
12 S Central Ave Idabel OK 74745-4626
Fax: (580) 286-3016
Website:
Authorized official contact:
Name: Nicholson, Jerry RPH

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 25-2838 Oklahoma
Suppliers / Long Term Care Pharmacy 3336L0003X

Profile Details

NPI number 1093808438
LBN Legal business name City Drug Of Idabel Inc
DBA Doing business as City Drug
Authorized official Nicholson, Jerry RPH
Entity Organization
Organization subpart 1 No
Enumeration date Sep 30th, 2006
Last updated Jul 2nd, 2014 - about 10 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 1093808438 NPPES
Oklahoma MEDICAID 100237680A
Oklahoma Other 2073563

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