| NPI | 1326188335 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA MARIE HICKS Billing 918-333-4848 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: OK 9-4296) |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2014-10-13 |