| NPI | 1477638567 |
|---|---|
| Doing Business As | BOULEVARD PHARMACY |
| Entity Type | Organization |
| Authorized Contact | JACEY COLE Owner 918-336-2140 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 333600000X Pharmacy | |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| 3336L0003X Pharmacy, Long Term Care Pharmacy | |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2021-12-08 |