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Organization

CLAREMORE COMPOUNDING CENTER, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. L. DAVID BRIM II DPH (CO-OWNER)
(918) 283-3784
Entity
Organization

Contact information

Practice address
1151 N LYNN RIGGS BLVD, CLAREMORE, OK 74017-3068
(918) 283-3784
(918) 343-1303
Mailing address
1151 N LYNN RIGGS BLVD, CLAREMORE, OK 74017-3068
(918) 283-3784
(918) 343-1303

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
294671
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
294671
PHARMACY LIC
OK
01
3722205
NABP
OK
Enumeration date
12/19/2006
Last updated
08/22/2020
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