Organization
CENTRAL DRUG LLC
Active
Other names
Cement Drug LLC
Organization subpart
No
Provider details
NPI number
Authorized official
GLENN GILBREATH JR. (OWNER/MANAGER)
(405) 224-2858
Entity
Organization
Contact information
Practice address
307 N MAIN ST, CEMENT, OK 73017-0300
(405) 489-3521
(405) 489-3521
Mailing address
PO BOX 300, CEMENT, OK 73017-0300
(405) 489-3521
(405) 489-3521
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
20-5654
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2130561
PK
—
Enumeration date
03/24/2011
Last updated
09/04/2013
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