| NPI | 1770653859 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LENDELL HICKS PIC 405-682-1648 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: OK 1-3336) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2011-01-28 |