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Jack Justice
Compounding Pharmacy in Pauls Valley, Oklahoma
NPI 1699772806

Jack Justice is a Compounding Pharmacy based in Pauls Valley, OK and is specialized in Compounding Pharmacy. Jack Justice practices in Pauls Valley, OK. The NPI Number for Jack Justice is 1699772806 and holds a License No. (Oklahoma).

The current practice location address for Jack Justice is 110 A Burr Ave, Pauls Valley, OK and can be reached out via phone at 405-238-7391 and via fax at 405-238-7357.

Location: 110 A Burr Ave, Pauls Valley, OK, 73075-2020
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1699772806
Provider Name
Jack Justice
Credential
Provider Entity Type
Organization
Address
110 A Burr Ave, Pauls Valley, OK, 73075-2020
Phone Number
405-238-7391
Fax Number
405-238-7357
Provider Enumeration Date
07/01/2005
Last Update Date
11/16/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
2073053 01 PK
100235750A 05 OK
institution
Provider Business Practice Location Address Details
Address
110 A Burr Ave
City
Pauls Valley
State
Oklahoma
Zip
73075-1220
Phone Number
405-238-7391
Fax Number
405-238-7357
person
Provider Business Mailing Address Details
Address
110 A Burr Ave
City
Pauls Valley
State
Oklahoma
Zip
73075-1220
Phone Number
405-238-7391
Fax Number
405-238-7357
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Durable Medical Equipment & Medical Supplies
Speciality
-
Taxonomy
332B00000X
License No.
()
Definition
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.
person
Provider's Taxonomy Details 2
Type
Suppliers
Classification
Pharmacy
Speciality
Community/Retail Pharmacy
Taxonomy
3336C0003X
License No.
22-3755 (Oklahoma)
Definition
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
person
Provider's Taxonomy Details 3
Type
Suppliers
Classification
Pharmacy
Speciality
Compounding Pharmacy
Taxonomy
3336C0004X
License No.
()
Definition
A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner's Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compounding practice.
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