Provider Demographics
NPI:1548306368
Name:FIKES PHARMACY, INC.
Entity type:Organization
Organization Name:FIKES PHARMACY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:B
Authorized Official - Last Name:FIKES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-479-5696
Mailing Address - Street 1:PO BOX 159
Mailing Address - Street 2:
Mailing Address - City:GRANDFIELD
Mailing Address - State:OK
Mailing Address - Zip Code:73546-0159
Mailing Address - Country:US
Mailing Address - Phone:580-479-5696
Mailing Address - Fax:580-479-5662
Practice Address - Street 1:101 E. 2ND STREET
Practice Address - Street 2:
Practice Address - City:GRANDFIELD
Practice Address - State:OK
Practice Address - Zip Code:73546
Practice Address - Country:US
Practice Address - Phone:580-479-5696
Practice Address - Fax:580-479-5662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK42-4672332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX580095Medicaid
OK100245210BMedicaid
OK100245210BMedicaid