| NPI | 1679905384 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICIA SELF Compliance 541-231-6327 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: OK 16350) |
| Enumeration Date | 2013-08-05 |
| Last Update Date | 2013-08-05 |