Last Updated:  12/22/2024 7:09:13 PM

Pharmacy Detail                               

Corporation / Company Owner Name

 

Business (DBA) Name  

MANGUM CITY HOSPITAL 

License Number 

60-4819 

Type of Pharmacy

Hospital Drug Room 

Address

ONE WICKERSHAM DR

PO BOX 148

City, State, Zip 

MANGUM, OK  73554-0148

Country 

 

Issue Date 

01/01/2004 

Renewed Date

12/23/2005

Expiration Date 

01/31/2007 

End Date 

05/04/2006 

Replacing

Replaced By

60-5092

Drug Supplier

No 

Sterile Compounding

No 

Training Area

No 

Unused Drug Dispensing

No 

LTC Emergency Kit

No

Pharmacist-In-Charge

GEORGE L. ROACH - 7286

Status

CLOSED 

In Process?

 

Disciplinary Action
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Case Date  

Case Number  

No Disciplinary Action 

 

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