Onesource LLC
Organization Active NPI Community/Retail Pharmacy · Caddo, OK
NPI 1154733293 · NPPES record last updated Jun 16, 2018
Key facts
- NPI
- 1154733293
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 27-6731 (OK)
- Legal business name
- ONESOURCE LLC
- Practice address
- 124 Buffalo St
Caddo, OK 74729-2606 - Phone
- (580) 279-6001
- Fax
- (580) 367-2206
- NPI assigned
- May 23, 2014
- Organization subpart
- No
Authorized official
- Name
- Tony Hudgins
- Title
- President
- Phone
- (580) 279-6001
Corporate family (same tax ID) 2
National Provider Directory
- Tax ID family
- Onesource
Locations
124 Buffalo St
Caddo, OK 74729
Phone (580) 279-6001
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 27-6731 | OK | Yes |
Addresses
Primary practice location
124 Buffalo St
Caddo, OK 74729-2606
Mailing address
31 Liberty St
Calera, OK 74730-5519
Phone (580) 302-2322
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200447310B | Medicaid | OK | |
| 2145875 | Other | PK |
Other names
- OneSource
Other providers in Caddo, OK
All providers in Caddo, 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 Jun 16, 2018. 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.