Provider Demographics
NPI:1598757650
Name:MED-WORLD PHARMACY, INC.
Entity Type:Organization
Organization Name:MED-WORLD PHARMACY, INC.
Other - Org Name:SAME
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:CURTIS
Authorized Official - Suffix:
Authorized Official - Credentials:DPH
Authorized Official - Phone:918-227-2010
Mailing Address - Street 1:14 S MISSION ST
Mailing Address - Street 2:
Mailing Address - City:SAPULPA
Mailing Address - State:OK
Mailing Address - Zip Code:74066-4634
Mailing Address - Country:US
Mailing Address - Phone:918-227-2010
Mailing Address - Fax:918-227-2843
Practice Address - Street 1:14 S MISSION ST
Practice Address - Street 2:
Practice Address - City:SAPULPA
Practice Address - State:OK
Practice Address - Zip Code:74066-4634
Practice Address - Country:US
Practice Address - Phone:918-227-2010
Practice Address - Fax:918-227-2843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK11-2456333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK0518000001Medicare NSC