| NPI | 1215671151 |
|---|---|
| Doing Business As | 1893 PHARMACY |
| Entity Type | Organization |
| Authorized Contact | HENRY (JAY) W KINNARD Pharmacy Manager 405-550-5315 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 3336S0011X Pharmacy, Specialty Pharmacy |
| Enumeration Date | 2022-04-26 |
| Last Update Date | 2022-04-28 |