Penny D Southern is a Pharmacist in Shawnee, Oklahoma. Penny D Southern practices all healthcare services and medical treatments related to Pharmacist. The NPI Number for Penny D Southern is 1659307460. The last update date is 2007-07-08.
Penny D Southern's current location address is 2307 S Gordon Cooper Dr, Shawnee, Oklahoma. You can contact this provider via phone number 4052735236 and fax number 4052732392. The mailing address for Penny D Southern is 2307 S Gordon Cooper Dr, Shawnee, Oklahoma. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Penny D Southern |
|---|---|
| Address | 2307 S Gordon Cooper Dr, Shawnee, Oklahoma |
| Phone Number | 4052735236 |
| Fax Number | 4052732392 |
| Sole Proprietor | N |
| Credentials | DPH |
NPI Number Detail
| NPI Number | 1659307460 |
|---|---|
| Provider Enumeration Date | 2006-06-23 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 2307 S Gordon Cooper Dr |
|---|---|
| City | Shawnee |
| State | Oklahoma (OK) |
| Post Code | 748019007 |
| Phone Number | 4052735236 |
| Fax Number | 4052732392 |
Provider's Primary Taxonomy Detail
| Speciality | Pharmacist |
|---|---|
| Taxonomy | 183500000X |
| Licence No | 10652 |
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Definition: An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or m |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 10652 | OK | STATE BOARD OF PHARMACY # |
Post Comment/ Review Below
What is the unique identifier code issued to Penny D Southern by the Centers for Medicare & Medicaid Services (CMS)?
The Penny D Southern has been assigned the NPI (National Provider Identifier) 1659307460. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Can you provide the Penny D Southern's physical address?
The Penny D Southern is physically located at 2307 S Gordon Cooper Dr, in the city of Shawnee, OK, with the postal code 748019007.
What is Penny D Southern's specialized field of practice, and what is the corresponding taxonomy classification code?
The Penny D Southern's area of specialization is Pharmacist, and the corresponding taxonomy code that categorizes this field of practice is 183500000X.
When was the Penny D Southern's 1659307460 issued?
The Penny D Southern's 1659307460 was issued on 2006-06-23.
When was the information related to Penny D Southern most recently updated or refreshed?
The details pertaining to the Penny D Southern, including its address, specialty, and other relevant information, were last updated or refreshed on 2007-07-08.
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