| NPI | 1063472793 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS EDWARD SPELL Owner/Pharmacist 601-892-4061 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: MS 00613/01.1) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-03-25 |
| Last Update Date | 2008-04-24 |