| NPI | 1831208719 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DUSTY ALLEN Director Of Pharmacy 918-756-9909 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332800000X Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy (Licence: OK 484151) |
| Additional Taxonomies | 3336S0011X Pharmacy Specialty Pharmacy |
| 333600000X Pharmacy | |
| 3336C0003X Pharmacy Community/Retail Pharmacy | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2021-10-27 |