Granite Drug Store
LBN: Granite Drug, Inc
Granite Drug Store is an health care organization with primary practice located at 316 Main St , Granite OK 73547-0158. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy, Suppliers / Mail Order Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Granite Drug, Inc can be contacted via phone (580) 535-2130, or through Cross, Lionel via phone (580) 535-2130.
Contact Information
Primary practice address
316 Main St
Granite OK 73547-0158
Phone: (580) 535-2130
Fax: (580) 535-2001
Website:
Authorized official contact:
Name: Cross, Lionel Doctor of Public Health (DPH)
Phone: (580) 535-2130
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 601729 | Oklahoma |
| Suppliers / Compounding Pharmacy | 3336C0004X | ||
| Suppliers / Mail Order Pharmacy | 3336M0002X |
Profile Details
| NPI number | 1295804920 |
|---|---|
| LBN Legal business name | Granite Drug, Inc |
| DBA Doing business as | Granite Drug Store |
| Authorized official | Cross, Lionel Doctor of Public Health (DPH) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Nov 7th, 2006 |
| Last updated | Jul 23rd, 2015 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1295804920 | NPPES |
| Oklahoma | MEDICAID | 100232860A | |
| Oklahoma | Other | 2072794 |
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