Organization
DIELRX
Active
Other names
Family Pharmacy #3
Organization subpart
No
Provider details
NPI number
Authorized official
GRANT DIEL (OWNER)
(580) 542-3232
Entity
Organization
Contact information
Practice address
221 S 30TH ST, ENID, OK 73701-6455
(580) 237-3801
Mailing address
915 E OWEN K GARRIOTT RD, ENID, OK 73701-6156
(580) 233-4244
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5-5533
OK
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200201750C
—
OK
01
—
2125454
PK
—
Enumeration date
06/16/2010
Last updated
05/12/2023
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