Organization
HALO RX LLC
Active
Other names
Halo Rx
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH BAILES (PHARMACIST IN CHARGE)
(580) 421-9885
Entity
Organization
Contact information
Practice address
703 N BROADWAY AVE, STE 3, ADA, OK 74820-3457
(580) 421-9885
(580) 421-9732
Mailing address
703 N BROADWAY AVE, STE 3, ADA, OK 74820-3457
(580) 421-9885
(580) 421-9732
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
235328
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2117706
PK
—
Enumeration date
11/07/2008
Last updated
04/09/2013
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