| NPI | 1639221492 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICH E DANDRIDGE Owner 918-456-2531 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: OK 12894) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: OK 36-5140) |
| 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: OK 36-5140) | |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2011-01-27 |