Organization
ZRC PHARMACY, LLC
Active
Other names
Clyde Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY CLYDE DPH (MANAGING MEMBER)
(405) 517-6104
Entity
Organization
Contact information
Practice address
7158 NW 112TH ST, OKLAHOMA CITY, OK 73162-2773
(405) 470-7008
(405) 470-1040
Mailing address
7158 NW 112TH ST, OKLAHOMA CITY, OK 73162-2773
(405) 517-6104
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-8329
PHARMACY LICENSE
OK
05
—
200809230A
—
OK
Enumeration date
12/03/2018
Last updated
01/25/2022
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