| NPI | 1285824128 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAD EMRY HESTON Owner 405-702-4747 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: OK 15219) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: OK 6125980001) |
| Enumeration Date | 2007-07-26 |
| Last Update Date | 2008-10-14 |