| NPI | 1720124936 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK G CORRALES Pharmacist 580-355-4540 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: OK 34620) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2008-08-12 |