| NPI | 1063831287 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN P HYATT General Manager Retail Pharmacy 314-251-7445 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2017-11-10 |