| NPI | 1457790545 |
|---|---|
| Former Legal Business Name | CENTRAL STATES ORTHOPEDIC |
| Entity Type | Organization |
| Authorized Contact | DENISE M PRIMEAUX Credentialing Coordinator 918-927-3226 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: OK 2-7169) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2013-06-21 |
| Last Update Date | 2024-03-06 |