| NPI | 1699841353 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NEIL DUCOTE VP Pharmacy 903-600-1376 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 3336C0004X Pharmacy Compounding Pharmacy |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: OK 36-5429) | |
| Enumeration Date | 2006-11-27 |
| Last Update Date | 2025-04-30 |