| NPI | 1285645846 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN MATLOCK Co Owner Mgr 405-733-2881 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: OK 13941) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 3336C0003X Pharmacy, Community/Retail Pharmacy | |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2008-02-04 |