| NPI | 1720001720 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIKE MILLER President 918-341-1236 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: OK 294542) |
| Additional Taxonomies | 3336C0004X Pharmacy Compounding Pharmacy |
| 3336L0003X Pharmacy Long Term Care Pharmacy | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2013-11-06 |