| NPI | 1750406757 |
|---|---|
| Doing Business As | TISHOMINGO INDIAN CLINIC PHARMACY |
| Entity Type | Organization |
| Authorized Contact | ZACH WILLIAMS Pharmacist 580-272-2710 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332800000X Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy (Licence: OK 61-6174) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0003X Pharmacy Community/Retail Pharmacy | |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2015-02-10 |