NPI | 1023725892 |
---|---|
Entity Type | Organization |
Authorized Contact | LAUREN VINSON DOWNING Pharmacist In Charge 270-519-9071 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0004X Pharmacy Compounding Pharmacy |
Enumeration Date | 2022-11-01 |
Last Update Date | 2022-11-01 |