Organization
KEENUM PHARMACY, LLC
Active
Other names
Rexco Drug & Gifts
Organization subpart
No
Provider details
NPI number
Authorized official
KYLE KEENUM (PHARMACY MANAGER)
(580) 477-0381
Entity
Organization
Contact information
Practice address
2101 N MAIN ST, ALTUS, OK 73521-1605
(580) 477-0381
(580) 477-1749
Mailing address
2101 N MAIN ST, ALTUS, OK 73521-1605
(580) 477-0381
(580) 477-1749
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200956270A
—
OK
Enumeration date
08/28/2020
Last updated
10/11/2021
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