| NPI | 1962842062 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMBERLYN HERD Pharmacy Director 405-271-6278 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: OK 1-5412) |
| Additional Taxonomies | 251V00000X Voluntary or Charitable (Licence: OK 1-5412) |
| 333600000X Pharmacy (Licence: OK 1-5412) | |
| 3336C0002X Pharmacy, Clinic Pharmacy (Licence: OK 1-5412) | |
| 3336M0002X Pharmacy, Mail Order Pharmacy (Licence: OK 1-5412) | |
| Enumeration Date | 2013-07-03 |
| Last Update Date | 2013-07-03 |