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 |