Organization
TOMS DRUG STORE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES RANDALL RPH (OWNER/PHARM)
(405) 375-3202
Entity
Organization
Contact information
Practice address
119 W ADMIRE AVE, KINGFISHER, OK 73750-2627
(405) 375-3202
(405) 375-6739
Mailing address
119 W ADMIRE AVE, KINGFISHER, OK 73750-2627
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
542015
OK
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3705552
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/30/2006
Last updated
02/06/2008
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