Provider Demographics
NPI:1538149976
Name:RAZOOK'S DRUG INC.
Entity type:Organization
Organization Name:RAZOOK'S DRUG INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JACK
Authorized Official - Middle Name:
Authorized Official - Last Name:RAZOOK
Authorized Official - Suffix:
Authorized Official - Credentials:DPH
Authorized Official - Phone:405-377-4445
Mailing Address - Street 1:1518 W 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74074-5468
Mailing Address - Country:US
Mailing Address - Phone:405-377-4445
Mailing Address - Fax:405-377-4448
Practice Address - Street 1:1518 W 9TH AVE
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74074-5468
Practice Address - Country:US
Practice Address - Phone:405-377-4445
Practice Address - Fax:405-377-4448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-20
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK8-2789332B00000X
332B00000X, 335E00000X, 333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK0334440001Medicare NSC