Pruetts Food Inc
Community/Retail Pharmacy
201 S Park Dr, Broken Bow
Oklahoma, 74728-4737
580-584-6085 580-584-6088
Pruetts Food Inc is a Community/Retail Pharmacy in Broken Bow, Oklahoma. It is located at 201 S Park Dr, Broken Bow and it's customer support contact number is 580-584-6085. The authorized person of Pruetts Food Inc is Shannon Jewelanna Pruett who is Pharmacy Director of the pharmacy and his contact number is 580-584-6089. Active license number of Pruetts Food Inc is 25-6949 for Community/Retail Pharmacy in Oklahoma. Pruetts Food Inc accepts medicare which means medicare covered patients will not be billed for any more than the Medicare deductible and coinsurance.
Pruetts Food Inc is 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.
Pharmacy Details:
Pruetts Food Inc type, location, contact phone number and fax are as below. Patients can directly walkin to the pharmacy or can call on the below given customer support phone number for enquiries.
| Name: | Pruetts Food Inc |
| Type: | Community/Retail Pharmacy |
| Location: | 201 S Park Dr, Broken Bow,
Oklahoma, 74728-4737 |
| Phone: | 580-584-6085 |
| Fax: | 580-584-6088 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this pharmacy is as below. Person's position and contact details are also mentioned below.
| Name: | Shannon Jewelanna Pruett |
| Position: | Pharmacy Director |
| Contact Number: | 580-584-6089 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of given pharmacy are as mentioned below.
| NPI Number: | 1689673832 |
| NPI Enumeration Date: | 19 Jul, 2005 |
| NPI Last Update On: | 31 Jan, 2021 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Pruetts Food Inc are as mentioned below.
| Specialization | License Number | State | Status | |
| Community/Retail Pharmacy | 25-6949 | Oklahoma | Primary | |
| Pharmacy | | | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers of the pharmacy such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 200019990A | Medicaid | Oklahoma | |
| 2076565 | Other | | Pk |
Medicare Enrollment:
Pruetts Food Inc is enrolled in medicare and it's Pac Id, enrollment Id, registered name and type is as stated below.
| PAC ID: |
Enrollment ID: |
Org Name | Medicare Entity Type |
| 9739157314 | O20040921001091 | Pruetts Food Inc | PART B SUPPLIER - MASS IMMUNIZATION (ROSTER BILLER ONLY) |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 210 Main Street,
Broken Bow, Oklahoma |
| Zip: | 74728-4737 |
| Phone Number: | 580-584-6056 |
| Fax Number: | 580-584-6088 |
Patients can reach Pruetts Food Inc at
201 S Park Dr, Broken Bow, Oklahoma or can
call on customer care at 580-584-6085.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.