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General NPI Number Information
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NPI Number | 1215643226
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Entity Type | Organization
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Legal Business Name | CRESCENT DRUG AND APOTHECARY LLC
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Dates
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Enumeration Date | 01/24/2023
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Last Update Date | 01/24/2023
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Provider Practice Location Address
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Address Line | 116 S DEAN A MCGEE AVE
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City | WYNNEWOOD
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State | OK
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Zip | 73098-7822
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Country | US
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Telephone | 405-665-4115
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Fax | 405-665-5666
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Provider Business Mailing Address
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Address Line | 116 S DEAN A MCGEE AVE
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City | WYNNEWOOD
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State | OK
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Zip | 73098-7822
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Country | US
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Telephone | 405-665-4115
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Fax | 405-665-5666
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Authorized Official
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Title or Position | OWNER
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Name | RORY FORINASH
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Credential |
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Telephone | 405-212-3177
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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