| NPI | 1942340898 |
|---|---|
| Doing Business As | FOUNTAIN PARK PHARMACY |
| Entity Type | Organization |
| Authorized Contact | ED GRAY Managing Member 405-419-7716 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: OK 1-5137) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2020-08-22 |