| NPI | 1700509544 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLEE MARIE KERN President 580-255-6292 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| Enumeration Date | 2022-09-26 |
| Last Update Date | 2022-09-26 |