NPI | 1053924969 |
---|---|
Entity Type | Organization |
Authorized Contact | KYLE KEENUM Pharmacy Manager 580-477-0381 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
Additional Taxonomies | 3336C0004X Pharmacy Compounding Pharmacy |
Enumeration Date | 2020-08-28 |
Last Update Date | 2021-10-11 |