Provider Demographics
NPI:1770665572
Name:DON'S DISCOUNT PHARMACY
Entity Type:Organization
Organization Name:DON'S DISCOUNT PHARMACY
Other - Org Name:DON'S DISCOUNT PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:DON
Authorized Official - Last Name:WOOLLY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:405-527-2186
Mailing Address - Street 1:204 WEST MAIN
Mailing Address - Street 2:DON'S DISCOUNT PHARMACY
Mailing Address - City:PURCELL
Mailing Address - State:OK
Mailing Address - Zip Code:73080
Mailing Address - Country:US
Mailing Address - Phone:405-527-2186
Mailing Address - Fax:405-527-2713
Practice Address - Street 1:204 WEST MAIN
Practice Address - Street 2:DON'S DISCOUNT PHARMACY
Practice Address - City:PURCELL
Practice Address - State:OK
Practice Address - Zip Code:73080
Practice Address - Country:US
Practice Address - Phone:405-527-2186
Practice Address - Fax:405-527-2713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
OK4752933336C0003X
OK47-52933336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100234930AMedicaid
3707392OtherNCPDP PROVIDER IDENTIFICATION NUMBER