| NPI | 1841255379 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATT BINTZ Owner/President 580-765-3055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: OK 6-5771) |
| Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy |
| 3336L0003X Pharmacy, Long Term Care Pharmacy | |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2020-08-10 |