Provider Demographics
NPI:1083770358
Name:DONS PHARMACY LIMITED
Entity Type:Organization
Organization Name:DONS PHARMACY LIMITED
Other - Org Name:DONS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BILL
Authorized Official - Middle Name:
Authorized Official - Last Name:WITTROCK
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:405-789-2453
Mailing Address - Street 1:6801 NW 39TH EXPY
Mailing Address - Street 2:
Mailing Address - City:BETHANY
Mailing Address - State:OK
Mailing Address - Zip Code:73008-2599
Mailing Address - Country:US
Mailing Address - Phone:405-789-2453
Mailing Address - Fax:405-789-2519
Practice Address - Street 1:6801 NW 39TH EXPY
Practice Address - Street 2:
Practice Address - City:BETHANY
Practice Address - State:OK
Practice Address - Zip Code:73008-2599
Practice Address - Country:US
Practice Address - Phone:405-789-2453
Practice Address - Fax:405-789-2519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-29
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
OK1-2333336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100232610AMedicaid
2072644OtherPK