Provider Demographics
NPI:1790718567
Name:AAA PHARMACY INC
Entity Type:Organization
Organization Name:AAA PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:SENTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-601-7469
Mailing Address - Street 1:500 W MAIN ST
Mailing Address - Street 2:#607
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73102-2208
Mailing Address - Country:US
Mailing Address - Phone:405-601-7469
Mailing Address - Fax:
Practice Address - Street 1:304 C S BROADWAY
Practice Address - Street 2:
Practice Address - City:HOBART
Practice Address - State:OK
Practice Address - Zip Code:73651-0586
Practice Address - Country:US
Practice Address - Phone:405-601-7469
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK41-49683336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5312570001Medicare ID - Type Unspecified