Organization
THE KIDS INVESTMENT CORP
Active
Other names
Granite Drug
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY TERRY (OWNER)
(580) 535-2130
Entity
Organization
Contact information
Practice address
316 MAIN ST, GRANITE, OK 73547-0158
(580) 535-2130
(580) 535-2001
Mailing address
PO BOX 158, GRANITE, OK 73547-0158
(580) 535-2130
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
60-7376
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2153944
PK
—
Enumeration date
07/06/2015
Last updated
01/14/2016
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