Organization
HENRY ROBERTS EXPRESS PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM DONALD MOORE PHARMD (PHARMACIST/OWNER)
(580) 223-5828
Entity
Organization
Contact information
Practice address
1316 12TH AVE NW, ARDMORE, OK 73401-1285
(580) 223-5828
(580) 226-3902
Mailing address
1316 12TH AVE NW, ARDMORE, OK 73401-1285
(580) 223-5828
(580) 226-3902
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
125653
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100244950
—
OK
Enumeration date
06/05/2014
Last updated
06/06/2014
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