Pruett'S Food-Pharmacy#10

LBN: Pruett'S Food, Inc.
Pruett'S Food-Pharmacy#10 is an health care organization with primary practice located at 1601 N Broadway Ave , Ada OK 74820-1403. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Pruett'S Food, Inc. can be contacted via phone (580) 436-0900, or through Pruett, Shannon via phone (580) 584-6056.

Contact Information

Primary practice address
1601 N Broadway Ave Ada OK 74820-1403
Phone: (580) 436-0900
Fax: (580) 332-2541
Website:
Map and Directions
Authorized official contact:
Name: Pruett, Shannon
Phone: (580) 584-6056

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X 237926 Oklahoma
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1699205575
LBN Legal business name Pruett'S Food, Inc.
DBA Doing business as Pruett'S Food-Pharmacy#10
Authorized official Pruett, Shannon
Entity Organization
Organization subpart 1 No
Enumeration date Jun 14th, 2017
Last updated Nov 28th, 2021 - about 3 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 1699205575 NPPES
Other 2169412 PK
MEDICAID 200019990H PK

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