Organization
REXCO DRUG OF ALTUS INC
Active
Other names
REXCO DRUG
Organization subpart
No
Provider details
NPI number
Authorized official
LONNIE LONG (PRESIDENT)
(580) 477-0381
Entity
Organization
Contact information
Practice address
2101 N MAIN ST, ALTUS, OK 73521-1605
(580) 477-0381
(580) 477-1749
Mailing address
2101 N MAIN ST, ALTUS, OK 73521-1605
(580) 477-0381
(580) 477-1749
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
175286
OK
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100241510A
—
OK
01
—
2074507
PK
—
Enumeration date
11/07/2006
Last updated
12/18/2016
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