| NPI | 1487365557 |
|---|---|
| Doing Business As | ICIO PROHEALTH PHARMACY - PRO HEALTH PHARMACY-#4188 |
| Entity Type | Organization |
| Authorized Contact | MICHAEL L WEED Treasurer 405-951-2737 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336S0011X Pharmacy, Specialty Pharmacy |
| Enumeration Date | 2022-12-09 |
| Last Update Date | 2025-11-06 |