| NPI | 1013408772 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL MARION COSTELLO President 256-566-8011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy, Compounding Pharmacy (Licence: AL 114813) |
| Enumeration Date | 2018-05-29 |
| Last Update Date | 2018-05-29 |