Last Updated: 12/22/2024 7:09:13 PM
Pharmacy
Detail
Corporation / Company Owner Name |
BLACKHAWK MANGUM, LLC |
Business (DBA) Name |
QUARTZ MOUNTAIN MEDICAL CENTER |
License Number |
60-5092 |
Type of Pharmacy |
Hospital Drug Room |
Address |
ONE WICKERSHAM DR |
City, State, Zip |
MANGUM,
OK 73554-9117 |
Country |
|
Issue Date |
05/04/2006 |
Renewed Date |
06/02/2017 |
Expiration Date |
05/31/2018 |
End Date |
07/10/2017 |
Replacing |
|
Replaced By |
|
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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that column.
No Disciplinary
Action |
|
|