| 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 |