Organization
DIELRX
Active
Other names
Family Pharmacy #1
Organization subpart
No
Provider details
NPI number
Authorized official
GRANT DIEL (MANAGER)
(580) 233-4244
Entity
Organization
Contact information
Practice address
826 E GARRIOTT RD, ENID, OK 73701-6156
(580) 233-4244
(580) 233-5319
Mailing address
826 E GARRIOTT RD, ENID, OK 73701-6156
(580) 233-4244
(580) 233-5319
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5-5857
OK
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100238050A
—
OK
Enumeration date
10/17/2006
Last updated
05/12/2023
Update your record
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