PHILLIP W & PHYLLIS J MELTON
1104 E Central Blvd Suite 1
Anadarko, OK 73005
405-247-3081
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
N | 3336L0003X | Suppliers - Pharmacy - Long Term Care Pharmacy | ||
N | 333600000X | Suppliers - Pharmacy | ||
Y | 3336C0003X | Suppliers - Pharmacy | OK | 20-4065 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
100804450E | OK | MEDICAID | |
PK | 2075827 | OTHER |