Organization
FLOURISH INTEGRATIVE PHARMACY LLC
Active
Other names
FLOURISH PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JERROD ROBERTS DPH (OWNER)
(405) 751-3333
Entity
Organization
Contact information
Practice address
14720 N PENNSYLVANIA AVE, OKLAHOMA CITY, OK 73134-6120
(405) 751-3333
(405) 751-3848
Mailing address
14720 N PENN AVE, OKLAHOMA CITY, OK 73134-6120
(405) 751-3333
(405) 751-3848
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
1-6316
OK
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2076566
PK
—
Enumeration date
12/20/2006
Last updated
01/07/2015
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