Organization
E D ALLENS PHARMACY OF BROKEN BOW INC
Active
Other names
EDDIE ALLENS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
EDDIE ALLEN (MANAGER)
(580) 584-5841
Entity
Organization
Contact information
Practice address
619 S PARK DR, BROKEN BOW, OK 74728-5331
(580) 584-5841
(580) 584-5845
Mailing address
619 S PARK DR, BROKEN BOW, OK 74728-5331
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
255237
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100237740A
—
OK
01
—
2073473
PK
—
Enumeration date
12/15/2006
Last updated
06/07/2016
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