| NPI | 1124427745 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AARON KANWHEN Pharmacy Manager 918-505-9650 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: OK 2-6814) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2014-08-19 |
| Last Update Date | 2017-04-04 |