Provider Demographics
NPI:1679252209
Name:STROUD DRUG HOLDING LLC
Entity type:Organization
Organization Name:STROUD DRUG HOLDING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BILL
Authorized Official - Middle Name:R
Authorized Official - Last Name:ASH
Authorized Official - Suffix:
Authorized Official - Credentials:DPH
Authorized Official - Phone:918-968-2323
Mailing Address - Street 1:406 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:STROUD
Mailing Address - State:OK
Mailing Address - Zip Code:74079-3614
Mailing Address - Country:US
Mailing Address - Phone:918-968-2323
Mailing Address - Fax:866-728-9131
Practice Address - Street 1:406 W MAIN ST
Practice Address - Street 2:
Practice Address - City:STROUD
Practice Address - State:OK
Practice Address - Zip Code:74079-3614
Practice Address - Country:US
Practice Address - Phone:918-968-2323
Practice Address - Fax:866-728-9131
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STROUD DRUG HOLDING LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-07-12
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy