Organization
OK COMPOUNDING LLC
Active
Other names
OK Compounding
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER PARKS (PARTNER/MANAGING OFFICER)
(918) 396-0100
Entity
Organization
Contact information
Practice address
102 N BROADWAY, SKIATOOK, OK 74070
(918) 396-0100
(918) 396-0113
Mailing address
102 N BROADWAY, SKIATOOK, OK 74070
(918) 396-0100
(918) 396-0113
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
2-6161
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2139818
PK
—
Enumeration date
11/04/2010
Last updated
05/08/2013
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