NPI | 1235946351 |
---|---|
Entity Type | Organization |
Authorized Contact | JOEL DAVENPORT Owner 405-248-8455 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy |
Enumeration Date | 2024-12-12 |
Last Update Date | 2025-03-03 |