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General NPI Number Information
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NPI Number | 1598232969
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Entity Type | Organization
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Legal Business Name | NUGENEREX POK1 LLC
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Dates
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Enumeration Date | 10/24/2018
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Last Update Date | 10/24/2018
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Provider Practice Location Address
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Address Line | 804 W I 240 SERVICE RD STE F
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City | OKLAHOMA CITY
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State | OK
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Zip | 73139-4555
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Country | US
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Telephone | 405-378-4210
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Fax | 405-378-4211
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Provider Business Mailing Address
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Address Line | 10102 USA TODAY WAY
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City | MIRAMAR
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State | FL
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Zip | 33025-3903
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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 | OFFICER
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Name | ANTHONY CRISCI
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Credential |
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Telephone | 914-527-1183
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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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