Provider Demographics
NPI:1891551057
Name:ERNIE'S PHARMACY & WELLNESS CENTER, INC.
Entity Type:Organization
Organization Name:ERNIE'S PHARMACY & WELLNESS CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERNIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:SYKORA
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:918-683-0611
Mailing Address - Street 1:410 S 32ND ST
Mailing Address - Street 2:
Mailing Address - City:MUSKOGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74401-5007
Mailing Address - Country:US
Mailing Address - Phone:918-816-1967
Mailing Address - Fax:
Practice Address - Street 1:410 S 32ND ST
Practice Address - Street 2:
Practice Address - City:MUSKOGEE
Practice Address - State:OK
Practice Address - Zip Code:74401-5007
Practice Address - Country:US
Practice Address - Phone:918-816-1967
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ERNIE'S PHARMACY & WELLNESS CENTER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy