Organization
TONI'S WESTSIDE REXALL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TONI K GIBSON DPH (CHIEF PHARMACIST OWNER)
(580) 765-4456
Entity
Organization
Contact information
Practice address
301 W GRAND AVE, PONCA CITY, OK 74601-5118
(580) 765-4456
(580) 765-0668
Mailing address
301 W GRAND AVE, PONCA CITY, OK 74601-5118
(580) 765-4456
(580) 765-0668
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
6-2133
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100235620B
—
OK
Enumeration date
01/25/2007
Last updated
04/30/2021
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