Phillip W & Phyllis J Melton
Organization Active NPI Community/Retail Pharmacy · Apache, OK
NPI 1043393093 · NPPES record last updated Jan 18, 2017
Key facts
- NPI
- 1043393093
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 203327 (OK)
- Legal business name
- PHILLIP W & PHYLLIS J MELTON
- Practice address
- 118 E Evans
Apache, OK 73006-9802 - Phone
- (580) 588-3639
- Fax
- (580) 588-3638
- NPI assigned
- Oct 23, 2006
- Organization subpart
- No
Authorized official
- Name
- Philip Melton, RPH
- Title
- Owner
- Phone
- (405) 247-3081
Corporate family (same tax ID) 1
National Provider Directory
- Tax ID family
- Apache Drug
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 203327 | OK | Yes |
Addresses
Primary practice location
118 E Evans
Apache, OK 73006-9802
Mailing address
PO Box 315
Apache, OK 73006-0315
Phone (580) 588-3639
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2074309 | Other | PK | |
| 100804450C | Medicaid | OK | |
| 90003923018 | Medicaid | OK |
Other names
- APACHE DRUG
Other providers in Apache, OK
- Comanche County Hospital Authority
- Sheryl Lynn Denton
- Wendy Harvey
- Deidra Henderson
- Helena M Hill
- Cheyenne Townley
- Megan Twohatchet
All providers in Apache, OK · Community/Retail Pharmacy in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 18, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.