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 |