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General NPI Number Information
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NPI Number | 1568401941
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Entity Type | Organization
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Legal Business Name | WENJEST CORPORATION
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Dates
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Enumeration Date | 06/04/2006
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Last Update Date | 05/22/2008
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Provider Practice Location Address
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Address Line | 10011 SE 15TH ST
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City | MIDWEST CITY
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State | OK
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Zip | 73130-5625
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Country | US
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Telephone | 405-737-8100
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Fax | 405-733-1604
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Provider Business Mailing Address
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Address Line | 10011 SE 15TH ST
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City | MIDWEST CITY
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State | OK
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Zip | 73130-5625
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHARMACY SUPERVISOR
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Name | JULIE WILLIS
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Credential | RPH
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Telephone | 405-473-0094
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail 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 | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 1-5210
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License Number State | OK
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