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General NPI Number Information
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NPI Number | 1871771436
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Entity Type | Organization
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Legal Business Name | KRISTI SUE PRESLEY
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Dates
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Enumeration Date | 02/06/2008
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Last Update Date | 04/21/2015
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Provider Practice Location Address
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Address Line | 1419 COMMERCIAL AVE
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City | MOUNDS
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State | OK
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Zip | 74047
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Country | US
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Telephone | 918-827-6301
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Fax | 918-827-6296
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Provider Business Mailing Address
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Address Line | PO BOX 32
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City | MOUNDS
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State | OK
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Zip | 74047-0032
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Country | US
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Telephone | 918-827-6301
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Fax | 918-827-6296
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Authorized Official
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Title or Position | OWNER AND PHARMACIST
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Name | KRISTI PIOWATY
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Credential | RPH
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Telephone | 918-827-6301
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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 | 11-5102
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License Number State | OK
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