Provider Demographics
NPI:1235850421
Name:D & D PHARMACY INCORPORATED
Entity Type:Organization
Organization Name:D & D PHARMACY INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DOUG
Authorized Official - Middle Name:E
Authorized Official - Last Name:HORNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-721-9536
Mailing Address - Street 1:101 W AVENUE D
Mailing Address - Street 2:
Mailing Address - City:HEAVENER
Mailing Address - State:OK
Mailing Address - Zip Code:74937-3017
Mailing Address - Country:US
Mailing Address - Phone:918-653-4803
Mailing Address - Fax:918-653-3520
Practice Address - Street 1:101 W AVENUE D
Practice Address - Street 2:
Practice Address - City:HEAVENER
Practice Address - State:OK
Practice Address - Zip Code:74937-3017
Practice Address - Country:US
Practice Address - Phone:918-653-4803
Practice Address - Fax:918-653-3520
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:D & D PHARMACY INCORPORATED
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-09-07
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy