| NPI | 1710994751 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER SIPOLS Phcy Mgr 405-974-3119 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: OK 15067) |
| Additional Taxonomies | 3336C0002X Pharmacy, Clinic Pharmacy |
| 3336C0003X Pharmacy, Community/Retail Pharmacy | |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2020-08-22 |