| NPI | 1073814455 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICKY CHAMBERS VP 901-238-2477 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: SC 711226) |
| Enumeration Date | 2010-11-16 |
| Last Update Date | 2011-08-09 |