Organization
PHYSICIAN DIRECT RETAIL PHARMACY, LLC
Active
Other names
pdr
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH ORTON (MANAGING MEMBER)
(405) 206-1313
Entity
Organization
Contact information
Practice address
7725 W RENO AVE, OKLAHOMA CITY, OK 73127-9711
(405) 206-1313
(405) 376-6117
Mailing address
7725 W RENO AVE, OKLAHOMA CITY, OK 73127-9711
(405) 206-1313
(405) 376-6117
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
10/05/2017
Last updated
10/05/2017
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