NPI | 1578656732 |
---|---|
Doing Business As | BROADWAY CORNER DRUG |
Entity Type | Organization |
Authorized Contact | RHONDA MCCOMBS Co Owner Dr Of Phy 918-427-1985 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: OK 34-3763) |
Additional Taxonomies | 333600000X Pharmacy |
Enumeration Date | 2006-10-02 |
Last Update Date | 2016-04-19 |