| NPI | 1952345027 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA HLADIK Manager 405-377-4445 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: OK 8-2789) |
| Additional Taxonomies | 3336C0004X Pharmacy Compounding Pharmacy |
| 3336L0003X Pharmacy Long Term Care Pharmacy | |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2020-12-09 |