Organization
MARK'S PRESCRIPTION SHOP INC
Active
Other names
Country Boy Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATT EVANS D.PH. (PHARMACIST)
(405) 390-3205
Entity
Organization
Contact information
Practice address
1530 S CHOCTAW RD STE A, CHOCTAW, OK 73020-7096
(405) 390-3205
(405) 390-3206
Mailing address
1530 S CHOCTAW RD STE A, CHOCTAW, OK 73020-7096
(405) 390-3205
(405) 390-3206
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
1-4081
OK
Other
Enumeration date
04/19/2007
Last updated
12/09/2011
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