Last Updated:  5/5/2024 5:21:49 AM

Pharmacy Detail                               

Corporation / Company Owner Name

WAL-MART STORES EAST, LP 

Business (DBA) Name  

WAL-MART PHARMACY NO. 10-0022 

License Number 

30-4971 

Type of Pharmacy

Retail 

Address

4901 S MILL RD

City, State, Zip 

PRYOR, OK  74361

Country 

 

Issue Date 

02/25/2005 

Renewed Date

06/19/2023

Expiration Date 

06/30/2024 

End Date 

 

Replacing

30-3405

Replaced By

Drug Supplier

Yes 

Sterile Compounding

No 

Training Area

Yes 

Unused Drug Dispensing

No 

LTC Emergency Kit

No

Pharmacist-In-Charge

AMY R. VAUGHAN - 14592

Status

License in Good Standing 

In Process?

 

Disciplinary Action
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Case Date  

Case Number  

No Disciplinary Action 

 

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