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General NPI Number Information
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NPI Number | 1588779136
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Entity Type | Organization
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Legal Business Name | RALLS ENTERPRISES INC
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 07/20/2021
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Provider Practice Location Address
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Address Line | 1200 SE LINCOLN RD
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City | IDABEL
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State | OK
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Zip | 74745-7358
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Country | US
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Telephone | 580-286-2190
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Fax | 580-286-5260
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Provider Business Mailing Address
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Address Line | 1200 SE LINCOLN RD
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City | IDABEL
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State | OK
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Zip | 74745-7358
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Country | US
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Telephone | 580-286-2190
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Fax | 580-286-5260
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Authorized Official
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Title or Position | OWNER
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Name | W A RALLS
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Credential |
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Telephone | 580-286-2190
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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 | 25-4396
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License Number State | OK
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