| NPI | 1164774709 |
|---|---|
| Doing Business As | COUNTRY BOY PHARMACY |
| Entity Type | Organization |
| Authorized Contact | MATT EVANS Pharmacist/Owner 405-390-3205 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: OK 1-6052) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2012-10-05 |
| Last Update Date | 2016-08-25 |