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General NPI Number Information
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NPI Number | 1649901265
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Entity Type | Organization
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Legal Business Name | ROSE ROCK PHARMACY, LLC
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Dates
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Enumeration Date | 06/23/2022
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Last Update Date | 06/27/2022
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Provider Practice Location Address
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Address Line | 12100 S YUKON AVE STE A
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City | GLENPOOL
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State | OK
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Zip | 74033-6621
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Country | US
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Telephone | 918-321-4054
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Fax | 918-552-1030
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Provider Business Mailing Address
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Address Line | 12100 S YUKON AVE STE A
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City | GLENPOOL
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State | OK
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Zip | 74033-6621
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Country | US
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Telephone | 918-321-4054
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Fax | 918-552-1030
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Authorized Official
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Title or Position | OWNER/PHARMACIST IN CHARGE
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Name | DR. COLBY GREUEL
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Credential | PHARM. D.
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Telephone | 918-321-4054
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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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