| NPI | 1104236843 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMBRISH N PATEL Pharmacy Manager 405-370-4669 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: NM RP00007752) |
| Enumeration Date | 2014-05-03 |
| Last Update Date | 2014-05-03 |