Provider Demographics
NPI:1215972344
Name:CYRIL HOME CARE PHARMACY INC
Entity type:Organization
Organization Name:CYRIL HOME CARE PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHARMACIST-IN-CHARGE
Authorized Official - Prefix:DR
Authorized Official - First Name:CLIFFORD
Authorized Official - Middle Name:O
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:DP
Authorized Official - Phone:580-464-2453
Mailing Address - Street 1:PO BOX 676
Mailing Address - Street 2:
Mailing Address - City:CYRIL
Mailing Address - State:OK
Mailing Address - Zip Code:73029-0676
Mailing Address - Country:US
Mailing Address - Phone:580-464-2453
Mailing Address - Fax:580-464-3108
Practice Address - Street 1:214 MISSOURI AVE
Practice Address - Street 2:
Practice Address - City:CYRIL
Practice Address - State:OK
Practice Address - Zip Code:73029-0676
Practice Address - Country:US
Practice Address - Phone:580-464-2453
Practice Address - Fax:580-464-3108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK203958332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1051290001Medicare Oscar/Certification
OK=========Medicare ID - Type UnspecifiedMEDICARE PART B