| NPI | 1073091070 |
|---|---|
| Doing Business As | VINTAGE DRUG COMPANY |
| Entity Type | Organization |
| Authorized Contact | ZACK BRODERICK Pharmacist/Ower 580-332-3344 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: OK 23-8228) |
| Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy |
| Enumeration Date | 2018-08-01 |
| Last Update Date | 2025-10-03 |