| NPI | 1043604812 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN ADAMS Director Of Pharmacy 270-651-4334 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2015-03-19 |
| Last Update Date | 2023-03-30 |