Shattuck Pharmacy Management Inc
Community/Retail Pharmacy
522 S Main St, Shattuck
Oklahoma, 73858-9604
580-938-2854 580-938-2888
Shattuck Pharmacy Management Inc is a Community/Retail Pharmacy in Shattuck, Oklahoma. It is located at 522 S Main St, Shattuck and it's customer support contact number is 580-938-2854. The authorized person of Shattuck Pharmacy Management Inc is Kyle Johnson, DPH who is Pic of the pharmacy and his contact number is 580-938-2854. Active license number of Shattuck Pharmacy Management Inc is 75-5618 for Community/Retail Pharmacy in Oklahoma. Shattuck Pharmacy Management Inc accepts medicare which means medicare covered patients will not be billed for any more than the Medicare deductible and coinsurance.
Shattuck Pharmacy Management 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:
Shattuck Pharmacy Management 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: | Shattuck Pharmacy Management Inc |
| Type: | Community/Retail Pharmacy |
| Location: | 522 S Main St, Shattuck,
Oklahoma, 73858-9604 |
| Phone: | 580-938-2854 |
| Fax: | 580-938-2888 |
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: | Kyle Johnson |
| Credentials: | DPH |
| Position: | Pic |
| Contact Number: | 580-938-2854 |
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: | 1720163959 |
| NPI Enumeration Date: | 26 Oct, 2006 |
| NPI Last Update On: | 27 Oct, 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 Shattuck Pharmacy Management Inc are as mentioned below.
| Specialization | License Number | State | Status | |
| Community/Retail Pharmacy | 75-5618 | Oklahoma | Primary | |
| Durable Medical Equipment & Medical Supplies | | | Secondary | |
| Pharmacy | | | Secondary | |
| Compounding Pharmacy | | | Secondary | |
| Long Term Care 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 |
| 100243730A | Medicaid | Oklahoma | |
| 2074859 | Other | | Pk |
Medicare Enrollment:
Shattuck Pharmacy Management 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 |
| 6305982307 | O20091006000041 | Shattuck Pharmacy Management Inc | PART B SUPPLIER - MASS IMMUNIZATION (ROSTER BILLER ONLY) |
| 6305982307 | O20100930027732 | Shattuck Pharmacy Management Inc | DME SUPPLIER - PHARMACY |
Products Available:
Shattuck Pharmacy Management Inc has following products available for sale under medicare.
| Products: |
|---|
| • Blood Glucose Monitors & Supplies: Non-mail Order | • Canes & Crutches |
| • Commodes, Urinals, & Bedpans | • Diabetic Shoes & Inserts: Prefabricated |
| • Nebulizer Equipment & Supplies | • Ostomy Supplies |
| • Urological Supplies | • Walkers |
| • Wheelchair Seating/cushions | • Wheelchairs & Accessories: Standard Manual |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Po Box 99, 522 S. Main Street
Shattuck, Oklahoma |
| Zip: | 73858-0099 |
| Phone Number: | 580-938-2854 |
| Fax Number: | 580-938-2888 |
Patients can reach Shattuck Pharmacy Management Inc at
522 S Main St, Shattuck, Oklahoma or can
call on customer care at 580-938-2854.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.