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>> Pharmacist >> Pharmacy Service Providers

Registrant NPI Number: 1487934105

Individual Registrant:
Gender: F
Not Sole Proprietor

Location and contact information for practice:
11605 N 135TH EAST AVE  COLLINSVILLE, OK 74021-4807 US
Tel: 918-371-5563  Fax: 918-371-9362

Contact information for business:
11605 N 135TH EAST AVE  COLLINSVILLE, OK 74021-4807 US
Tel: 918-371-5563  Fax: 918-371-9362

Registration Information:
NPI: 1487934105
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y183500000XPharmacy Service Providers

Legacy codes, insurance codes and state license numbers:



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