Provider Demographics
NPI:1922445089
Name:METRO PHARMACY LLC
Entity Type:Organization
Organization Name:METRO PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:ATWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:405-919-5150
Mailing Address - Street 1:PO BOX 1160
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73083-1160
Mailing Address - Country:US
Mailing Address - Phone:405-513-8210
Mailing Address - Fax:405-513-8217
Practice Address - Street 1:125 E 3RD ST
Practice Address - Street 2:SUITE E
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-3821
Practice Address - Country:US
Practice Address - Phone:405-513-8210
Practice Address - Fax:405-513-8217
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-30
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
OK1-63103336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy
No333600000XSuppliersPharmacy