Organization
BENT WILLOW INC
Active
Other names
LAKESIDE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY HOFFMAN (PRESIDENT)
(918) 689-9940
Entity
Organization
Contact information
Practice address
605 N MAIN ST, EUFAULA, OK 74432-1634
(918) 689-9940
(918) 689-7557
Mailing address
605 N MAIN ST, EUFAULA, OK 74432-1634
(918) 689-9940
(918) 689-7557
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
02/13/2007
Last updated
08/22/2020
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