Last Updated: 12/5/2025 5:24:46 AM
Pharmacy
Detail
|
Corporation / Company Owner Name |
WAL-MART STORES EAST, LP |
|
Business (DBA) Name |
WAL-MART PHARMACY NO. 10-0103 |
|
License Number |
10-3399 |
|
Type of Pharmacy |
Retail |
|
Address |
4901 N KICKAPOO ST |
|
City, State, Zip |
SHAWNEE,
OK 74801-1397 |
|
Country |
|
|
Issue Date |
02/03/1989 |
|
Renewed Date |
06/14/2004 |
|
Expiration Date |
06/30/2005 |
|
End Date |
07/01/2004 |
|
Replacing |
|
|
Replaced By |
|
|
Drug Supplier |
No |
|
Sterile Compounding |
No |
|
Training Area |
No |
|
Unused Drug Dispensing |
No |
|
LTC Emergency Kit |
No |
|
Pharmacist-In-Charge |
KEVIN O. PHILLIPS - 12349 |
|
Status |
CLOSED |
|
In Process? |
|
|
|
|
|
|
|
Disciplinary Action
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that column.
|
No Disciplinary
Action |
|