| NPI | 1013473263 |
|---|---|
| Doing Business As | HEALTH DEPOT #1 |
| Entity Type | Organization |
| Authorized Contact | BREANN MASHBURN Billing Director 479-646-7875 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2019-02-13 |
| Last Update Date | 2019-02-13 |