| NPI | 1144227166 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAURY LEE CAMPBELL Pharmacist/Owner 405-707-3005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: OK 5294220001) |
| Additional Taxonomies | 333600000X Pharmacy (Licence: OK 84901) |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2020-08-22 |