| NPI | 1023195542 |
|---|---|
| Doing Business As | ESCATAWPA SAV-REX #636 |
| Entity Type | Organization |
| Authorized Contact | MODENA S CANNON Pharmacy Operations Manager 228-769-7067 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: MS 00840/01.2) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2020-08-22 |