| NPI | 1598053993 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOYLE FORTNEY West Clinic Manager 405-964-5770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332800000X Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy (Licence: OK 105576) |
| Enumeration Date | 2011-07-19 |
| Last Update Date | 2012-11-16 |