Gln Of Checotah Inc
May also be knows as Nichols Pharmacy
Community/Retail Pharmacy in Checotah, OK(View on Map)
Legal Business Name
Gln Of Checotah Inc
Also Known As
Nichols Pharmacy
NPI Number
1154416162
NPI Type
Organization
Enumeration Date
10/04/2006
Specialties
(Taxonomies)Code
3336C0003X
332B00000X
Primary Taxonomy
Yes
No
Licenses
State
Oklahoma
License Number
483935
Contact
Information
Purpose
Mailing
Location
Address
207 N BROADWAY ST
207 N BROADWAY ST
City
Checotah
Checotah
State
OK
OK
Postal Code
74426-2431
74426-2431
Country
US
US
Telephone Number
(918) 473-2304
(918) 473-2304
Authorized Official
Name
Dr. Amy Garrett
Title or Position
PHARMACY MANAGER
Telephone Number
(918) 473-2304
Identifiers
Identifier
100243600A
Identifier State
OK
Identifier Issuer
Unknown
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 03/15/2011
Provider Address
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