| NPI | 1427236256 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAD E. HESTON Pharmacist 405-702-4747 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: OK 1-5219) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: 6125980001) |
| Enumeration Date | 2008-02-04 |
| Last Update Date | 2008-10-14 |