Organization
CENTRAL OKLAHOMA FAMILY MEDICAL CENTER PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TONI F VANDEGRIFT DPH. (PHARMACY DIRECTOR)
(580) 925-8911
Entity
Organization
Contact information
Practice address
527 W 3RD ST, KONAWA, OK 74849-1415
(580) 925-8911
(580) 925-8920
Mailing address
527 W 3RD ST, KONAWA, OK 74849-1415
(580) 925-8911
(580) 925-8920
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
244685
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100737160
—
OK
Enumeration date
09/16/2009
Last updated
09/16/2009
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