| NPI | 1780988907 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN DOUGLAS LASSITER Owner 405-677-0549 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: OK 32-5603) |
| Additional Taxonomies | 3336C0004X Pharmacy Compounding Pharmacy |
| 3336L0003X Pharmacy Long Term Care Pharmacy | |
| Enumeration Date | 2011-01-03 |
| Last Update Date | 2017-10-26 |