| NPI | 1063948289 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRETA ISHMAEL Owner/AO 870-856-4696 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: AR AR20135) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2017-05-08 |
| Last Update Date | 2018-05-03 |