| NPI | 1063531044 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH DALE HARRELSON Pharmacist Owner 662-494-4748 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: MS 0202501.1) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2008-08-12 |