Organization
TELOS COMPOUNDING SOLUTIONS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACOBY GRAY PHARMD (MANAGING MEMBER)
(405) 706-0079
Entity
Organization
Contact information
Practice address
701 N MUSTANG RD STE C, YUKON, OK 73099-5671
(405) 706-0079
Mailing address
701 N MUSTANG RD STE C, YUKON, OK 73099-5671
(405) 706-0079
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
09/17/2025
Last updated
09/17/2025
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