| NPI | 1871213280 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLEE MARIE KERN President 580-252-0140 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition | |
| 333600000X Pharmacy | |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| Enumeration Date | 2022-08-29 |
| Last Update Date | 2023-05-24 |