| NPI | 1003332495 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA LOUISE LANEY Owner, Member 765-720-2569 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2017-08-17 |
| Last Update Date | 2022-07-21 |