| NPI | 1093462004 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAVISH NITINKUMAR SHAH Pharmacist In Charge 903-284-6256 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy |
| Enumeration Date | 2022-03-09 |
| Last Update Date | 2022-03-16 |