| NPI | 1942365879 |
|---|---|
| Doing Business As | FOUNTAIN PARK PHARMACY |
| Entity Type | Organization |
| Authorized Contact | ED GRAY Director 405-419-5478 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: OK 15137) |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2007-08-31 |