Provider Demographics
NPI:1952718009
Name:BMTTH, LLC
Entity Type:Organization
Organization Name:BMTTH, LLC
Other - Org Name:DURANT MEDICAL PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-924-0290
Mailing Address - Street 1:1028 CRISWELL DR STE 102
Mailing Address - Street 2:
Mailing Address - City:DURANT
Mailing Address - State:OK
Mailing Address - Zip Code:74701-1059
Mailing Address - Country:US
Mailing Address - Phone:580-920-1400
Mailing Address - Fax:580-920-1451
Practice Address - Street 1:1028 CRISWELL DR STE 102
Practice Address - Street 2:
Practice Address - City:DURANT
Practice Address - State:OK
Practice Address - Zip Code:74701-1059
Practice Address - Country:US
Practice Address - Phone:580-920-1400
Practice Address - Fax:580-920-1451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-21
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK275534333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy