Organization
RICHMARK INC
Active
Other names
Carel's Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK G CORRALES D.PH. (PHARMACIST)
(580) 355-4540
Entity
Organization
Contact information
Practice address
1810 W GORE BLVD, LAWTON, OK 73501-3615
(580) 355-4540
(580) 248-2012
Mailing address
1810 W GORE BLVD, LAWTON, OK 73501-3615
(580) 355-4540
(580) 248-2012
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
34620
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100242260A
—
OK
Enumeration date
01/29/2007
Last updated
08/12/2008
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