Organization
JAYMARC INC
Active
Other names
Roberts Drug Store
Organization subpart
No
Provider details
NPI number
Authorized official
MARK HOLLEY (OWNER)
(405) 257-3388
Entity
Organization
Contact information
Practice address
309 S WEWOKA AVE, WEWOKA, OK 74884-2641
(405) 257-3388
(405) 257-6508
Mailing address
PO BOX 728, WEWOKA, OK 74884-0728
(405) 257-3388
(405) 257-6508
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
24-5489
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200296660A
—
OK
01
—
2124569
PK
—
Enumeration date
04/12/2010
Last updated
01/11/2016
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