| NPI | 1598840670 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIM WEAVER Owner 405-947-6828 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: OK 12576) |
| Additional Taxonomies | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2020-08-22 |