| NPI | 1477631513 |
|---|---|
| Doing Business As | COUNTRY MART PHARMACY |
| Entity Type | Organization |
| Authorized Contact | KATIE LEIGH STINCHCOMB Pharmacy Manager 918-423-2980 |
| Organization Subpart ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OK 13390) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OK 10833) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2010-06-14 |