| NPI | 1811995301 |
|---|---|
| Former Legal Business Name | HENRYETTA DRUG |
| Entity Type | Organization |
| Authorized Contact | ELMER ALLEN FRECH Pharmacist/Owner 918-652-3361 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: OK 14-5411) |
| 3336L0003X Pharmacy, Long Term Care Pharmacy | |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2014-10-21 |