Provider Demographics
NPI:1316020365
Name:CAL DRUG LLC
Entity Type:Organization
Organization Name:CAL DRUG LLC
Other - Org Name:CAL DRUG LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DON
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCASLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-297-7283
Mailing Address - Street 1:401 HIGHWAY 270
Mailing Address - Street 2:
Mailing Address - City:HARTSHORNE
Mailing Address - State:OK
Mailing Address - Zip Code:74547-2800
Mailing Address - Country:US
Mailing Address - Phone:918-297-7283
Mailing Address - Fax:918-297-3748
Practice Address - Street 1:401 HIGHWAY 270
Practice Address - Street 2:
Practice Address - City:HARTSHORNE
Practice Address - State:OK
Practice Address - Zip Code:74547-2800
Practice Address - Country:US
Practice Address - Phone:918-297-7283
Practice Address - Fax:918-297-3748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336L0003X
OK15-52173336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2073725OtherPK
OK100236180AMedicaid