| NPI | 1083896195 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILL M GOOCH Pharmacist 662-534-4774 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MS 02138/01.1) |
| Enumeration Date | 2007-11-30 |
| Last Update Date | 2007-11-30 |