| NPI | 1194185504 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICKY BURGESS President 866-237-8217 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy (Licence: OK 2-7811) |
| Enumeration Date | 2016-02-26 |
| Last Update Date | 2017-02-24 |