Provider Demographics
NPI:1518903319
Name:THE STAR PHARMACY
Entity Type:Organization
Organization Name:THE STAR PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:405-381-2341
Mailing Address - Street 1:4817 NW 161ST ST
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-3204
Mailing Address - Country:US
Mailing Address - Phone:405-808-1524
Mailing Address - Fax:405-285-0455
Practice Address - Street 1:302 W MAIN ST
Practice Address - Street 2:
Practice Address - City:TUTTLE
Practice Address - State:OK
Practice Address - Zip Code:73089-9060
Practice Address - Country:US
Practice Address - Phone:405-381-2341
Practice Address - Fax:405-381-9896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK13224183500000X
OKT116183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty
Not Answered183700000XPharmacy Service ProvidersPharmacy TechnicianGroup - Multi-Specialty