# HALO RX LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Halo Rx
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790939494
- **Authorized official:** KENNETH BAILES (PHARMACIST IN CHARGE)
- **Authorized official phone:** (580) 421-9885

## Contact information

- **Practice address:** 703 N BROADWAY AVE, STE 3, ADA, OK 74820-3457
- **Practice address phone:** (580) 421-9885
- **Practice address fax:** (580) 421-9732
- **Mailing address:** 703 N BROADWAY AVE, STE 3, ADA, OK 74820-3457
- **Mailing address phone:** (580) 421-9885
- **Mailing address fax:** (580) 421-9732

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | 235328 | OK | Yes |

## Other

- **Enumeration date:** 11/07/2008
- **Last updated:** 04/09/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2117706 | PK | — |