Provider Demographics
NPI:1942604905
Name:SWOSU SCHOOL OF PHARMACY
Entity Type:Organization
Organization Name:SWOSU SCHOOL OF PHARMACY
Other - Org Name:SWOSU SCHOOL OF PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARM CARE II LAB COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DRINNON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-302-4297
Mailing Address - Street 1:100 CAMPUS DR
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:OK
Mailing Address - Zip Code:73096-3001
Mailing Address - Country:US
Mailing Address - Phone:580-774-6878
Mailing Address - Fax:
Practice Address - Street 1:100 CAMPUS DR
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:OK
Practice Address - Zip Code:73096-3001
Practice Address - Country:US
Practice Address - Phone:580-774-6878
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-20
Last Update Date:2014-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
OK28-19983336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2147965OtherPK