Organization
R&S DRUG STORE #1 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LESLEE MARIE KERN DPH (PRESIDENT)
(580) 255-6292
Entity
Organization
Contact information
Practice address
821 W MAIN ST, DUNCAN, OK 73533-4615
(580) 255-6292
(580) 255-6293
Mailing address
821 W MAIN ST, DUNCAN, OK 73533-4615
(580) 255-6292
(580) 255-6293
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200686130A
—
OK
Enumeration date
09/26/2022
Last updated
09/26/2022
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