Provider Demographics
NPI:1508371980
Name:ROWLAND PHARMACY, LLC
Entity Type:Organization
Organization Name:ROWLAND PHARMACY, LLC
Other - Org Name:ROWLAND PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDY
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:ROWLAND
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:918-236-4668
Mailing Address - Street 1:802 W MAIN ST STE 103
Mailing Address - Street 2:
Mailing Address - City:JENKS
Mailing Address - State:OK
Mailing Address - Zip Code:74037-3585
Mailing Address - Country:US
Mailing Address - Phone:918-236-4668
Mailing Address - Fax:918-574-8463
Practice Address - Street 1:802 W MAIN ST STE 103
Practice Address - Street 2:
Practice Address - City:JENKS
Practice Address - State:OK
Practice Address - Zip Code:74037-3585
Practice Address - Country:US
Practice Address - Phone:918-236-4668
Practice Address - Fax:918-574-8463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-07
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200769890AMedicaid