Organization
KENS RX DISCOUNT PHARMACY
Active
Other names
KENS RX
Organization subpart
No
Provider details
NPI number
Authorized official
ALECE NEWELL DPH (PHARMACY PARTNER)
(580) 353-4113
Entity
Organization
Contact information
Practice address
802 W GORE BLVD, LAWTON, OK 73501-3719
(580) 353-4113
(580) 357-3862
Mailing address
802 W GORE BLVD, LAWTON, OK 73501-3719
(580) 353-4113
(580) 357-3862
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
3-5058
OK
3336C0003X
Community/Retail Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100239000A
—
OK
01
—
2074055
PK
—
Enumeration date
01/16/2007
Last updated
04/24/2019
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