| NPI | 1003446162 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW SAMMONS Owner 606-220-2553 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2020-01-17 |
| Last Update Date | 2020-06-20 |