| NPI | 1598845000 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRANT DIEL Manager 580-233-4244 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: OK 5-5857) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0004X Pharmacy Compounding Pharmacy | |
| 3336L0003X Pharmacy Long Term Care Pharmacy | |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2023-05-12 |