Hometown Iga Pharmacy

NPI #1952515140 in Oklahoma City, Oklahoma

Provider Information

NPI Number: 1952515140
Entity Type: Organization
Organization Name: Hometown Iga Pharmacy
Primary Specialty: Pharmacist
Enumeration Date: May 9, 2007
Last Updated: Jun 19, 2008

Practice Location

Address: 2001 NE 23RD
City: Oklahoma City
State: Oklahoma
ZIP Code: 73111
Phone: (405) 424-4361

Authorized Official

Name: DR. LESLIE F GOODMAN, DR
Title: PHARMACY MANAGER
Phone: (405) 424-4361

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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