| NPI | 1063507267 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEN RALPH SHIPMAN Pharmacist Owner 409-384-4646 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TX 0659280001) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2023-11-08 |