FacilityDetail

Last Updated:  11/21/2024 7:05:00 PM

Facility Detail                       
Corporation / Company Owner Name MEDICAL SUPPORT SERVICES OF OKLAHOMA 
Business (DBA) Name   EDGEWATER PHARMACY 
License Number  1-P-193 
Facility Type Repackager 
Address

6436 N PORTLAND

City, State, Zip OKLAHOMA CITY,OK 73116-2000 
Country   
Issue Date  06/26/1987 
Renewed Date 06/30/1989
Expiration Date   
Renewal Month
End Date  03/19/1990 
Status CLOSED 
In Process?
 

Disciplinary Action
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Case Date   Case Number  
No records 
 

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