| NPI | 1083285225 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | ADEYEMI GEORGE Pharmacy Manager 817-538-5251  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy | 
| Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy | 
| Enumeration Date | 2021-07-08 | 
| Last Update Date | 2021-09-14 |