Organization
AZ RX COMPOUNDING PHARMACY, LLC.
Active
Other names
Texoma Compounding Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
A.J. ASGARI (PIC)
(405) 412-1404
Entity
Organization
Contact information
Practice address
2150 ED F DAVIS RD, DURANT, OK 74701-1053
(405) 412-1404
Mailing address
291 ROLLING WOOD HILLS DR, DURANT, OK 74701-1733
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
Primary
27-6518
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2143497
PK
—
Enumeration date
01/02/2014
Last updated
01/02/2014
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