Organization
CREST RX LLC
Active
Other names
CREST RX
Organization subpart
No
Provider details
NPI number
Authorized official
SARA JUSTICE (MANAGER)
(405) 378-7171
Entity
Organization
Contact information
Practice address
10601 S MAY AVE STE 11, OKLAHOMA CITY, OK 73170-2501
(405) 378-7171
(405) 378-7173
Mailing address
10601 S MAY AVE STE 11, OKLAHOMA CITY, OK 73170-2501
(405) 378-7171
(405) 378-7173
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
75537
OK
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200293490A
—
OK
01
—
2125510
PK
—
Enumeration date
06/18/2010
Last updated
10/28/2024
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