Provider Demographics
NPI:1649641861
Name:OSBORN DRUGS WAREHOUSE
Entity type:Organization
Organization Name:OSBORN DRUGS WAREHOUSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:EARL
Authorized Official - Last Name:OSBORN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:918-542-4444
Mailing Address - Street 1:103 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:OK
Mailing Address - Zip Code:74354-7024
Mailing Address - Country:US
Mailing Address - Phone:918-919-0637
Mailing Address - Fax:918-919-0637
Practice Address - Street 1:103 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:OK
Practice Address - Zip Code:74354-7024
Practice Address - Country:US
Practice Address - Phone:918-919-0637
Practice Address - Fax:918-919-0637
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OSBORN DRUGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-10-14
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK21-W-1433333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK21-W-1433OtherOKLAHOMA BOARD OF PHARMACY
OK47663OtherOBN