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General NPI Number Information
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NPI Number | 1306167572
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Entity Type | Organization
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Legal Business Name | BFL MLK LLC
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Dates
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Enumeration Date | 06/22/2010
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Last Update Date | 06/30/2010
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Provider Practice Location Address
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Address Line | 2001 NE 23RD ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73111-3401
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Country | US
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Telephone | 405-424-4361
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Fax | 405-424-4362
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Provider Business Mailing Address
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Address Line | 2129 W HEFNER RD
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City | OKLAHOMA CITY
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State | OK
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Zip | 73120-7601
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Country | US
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Telephone | 405-302-6273
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Fax | 405-302-0385
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MIKE BECKWITH
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Credential |
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Telephone | 405-302-6282
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 15536
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License Number State | OK
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