Organization
TWIN R NO 2 INC
Active
Other names
CREST RX PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MACVICTOR VIET KY NGUYEN (MANAGER)
(405) 741-4411
Entity
Organization
Contact information
Practice address
249 N DOUGLAS BLVD, MIDWEST CITY, OK 73130-3309
(405) 741-4411
(405) 733-7260
Mailing address
PO BOX 10763, MIDWEST CITY, OK 73140-1763
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
1-4593
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100234140A
—
OK
01
—
2072548
PK
—
Enumeration date
09/30/2006
Last updated
02/10/2025
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