| NPI | 1215202064 |
|---|---|
| Doing Business As | 23RD STREET PHARMACY |
| Entity Type | Organization |
| Authorized Contact | MICKEY PHAN Owner 405-513-0710 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: OK 16693) |
| Additional Taxonomies | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2012-03-13 |
| Last Update Date | 2016-06-16 |