Organization
RT FAMILY DISCOUNT PHARMACY
Active
Other names
Family Discount Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
TROY SIMONS (PRESIDENT)
(405) 742-8099
Entity
Organization
Contact information
Practice address
310 FAIRVIEW AVE, PONCA CITY, OK 74601-2001
(580) 762-6335
Mailing address
310 FAIRVIEW AVE, PONCA CITY, OK 74601-2001
(580) 762-6335
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100234470A
—
OK
Enumeration date
06/24/2019
Last updated
06/24/2019
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