| NPI | 1578709655 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICKEY DYER Manager 580-302-3563 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: OK 285342) |
| Additional Taxonomies | 3336L0003X Pharmacy Long Term Care Pharmacy |
| Enumeration Date | 2008-12-19 |
| Last Update Date | 2014-07-02 |