| NPI | 1295864072 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BILLIE SHIELDS Pharmacist 580-233-2157 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: OK 5683) |
| Additional Taxonomies | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2020-08-22 |