| NPI | 1962721464 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA BUTLER PIC/President 918-786-1092 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: OK 45-7418) |
| Additional Taxonomies | 3336C0004X Pharmacy Compounding Pharmacy |
| Enumeration Date | 2010-05-24 |
| Last Update Date | 2016-12-18 |