| NPI | 1073608840 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN C DAVIS Owner/Pharmacist 662-728-5732 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MS 00212011) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2020-08-22 |