Organization
FOSTER CORNER DRUG INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TROY SIMONS (OWNER AND PHARMACIST)
(580) 336-2136
Entity
Organization
Contact information
Practice address
328 N 6TH ST, PERRY, OK 73077-6607
(580) 336-2136
Mailing address
328 N 6TH ST, PERRY, OK 73077-6607
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
56-1529
OK
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100232750A
—
OK
Enumeration date
05/29/2007
Last updated
04/08/2013
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