| NPI | 1962556316 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEX KOURT VP 580-661-3549 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: OK 495139) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2020-08-22 |