Individual
MOSES NIMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMACIST
Contact information
Practice address
5046 S SHERIDAN RD, TULSA, OK 74145-5714
(918) 627-6464
Mailing address
4414 W MADISON PL, BROKEN ARROW, OK 74012-8542
(918) 406-0826
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
19381
OK
Other
Enumeration date
09/12/2021
Last updated
09/12/2021
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