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Organization
AZ RX COMPOUNDING PHARMACY, LLC.
Active
Organization
AZ RX COMPOUNDING PHARMACY, LLC.
Active
Other names
Texoma Compounding Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
A.J. ASGARI (PIC)
(405) 412-1404
Entity
Organization
Contact information
Practice address
2150 ED F DAVIS RD, DURANT, OK 74701-1053
(405) 412-1404
Mailing address
291 ROLLING WOOD HILLS DR, DURANT, OK 74701-1733
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
Primary
27-6518
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2143497
PK
—
Enumeration date
01/02/2014
Last updated
01/02/2014
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