Organization
MOORE PHARMACY SERVICE; LLC
Active
Other names
Select RX
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL BRENT MOORE (PRESIDENT/OWNER)
(918) 461-8103
Entity
Organization
Contact information
Practice address
11414 E. 51ST STREET, UNIT A, TULSA, OK 74146-5821
(918) 461-8103
(918) 461-9795
Mailing address
11414 E. 51ST STREET, UNIT A, TULSA, OK 74146-5821
(918) 461-8103
(918) 461-9795
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
24-610
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100247400A
—
OK
05
—
100247400B
—
OK
Enumeration date
10/02/2006
Last updated
02/15/2011
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