Provider Demographics
NPI:1467731760
Name:S AND H FAMILY PHARMACY SERVICES INCORPORATED
Entity Type:Organization
Organization Name:S AND H FAMILY PHARMACY SERVICES INCORPORATED
Other - Org Name:S & H FAMILY PHARMACY INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:SELF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-571-8813
Mailing Address - Street 1:710 E SHAWNTEL SMITH BLVD
Mailing Address - Street 2:SUITE D
Mailing Address - City:MULDROW
Mailing Address - State:OK
Mailing Address - Zip Code:74948-4830
Mailing Address - Country:US
Mailing Address - Phone:918-427-6060
Mailing Address - Fax:918-427-6097
Practice Address - Street 1:710 E SHAWNTEL SMITH BLVD STE D
Practice Address - Street 2:
Practice Address - City:MULDROW
Practice Address - State:OK
Practice Address - Zip Code:74948-4831
Practice Address - Country:US
Practice Address - Phone:918-427-6060
Practice Address - Fax:918-427-6097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-04
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3457333336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3726633OtherNCPDP PROVIDER IDENTIFICATION NUMBER