| NPI | 1013443811 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBIN L JACKSON Pharmacist 662-304-0181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: MS E-09982) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2017-05-11 |