Organization
NEW SPRING PHARMACY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KYLE RACKLEY (PRESIDENT)
(918) 938-0440
Entity
Organization
Contact information
Practice address
3462 W 151ST ST S, KIEFER, OK 74041-4549
(918) 938-0440
(918) 938-0543
Mailing address
3462 W 151ST ST S, KIEFER, OK 74041-4549
(918) 938-0440
(918) 938-0453
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
2-7751
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200671740A
—
OK
Enumeration date
09/27/2016
Last updated
07/06/2021
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