| NPI | 1104406511 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH PULLIAM CFO 903-531-4102 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 3336S0011X Pharmacy Specialty Pharmacy |
| Enumeration Date | 2021-04-09 |
| Last Update Date | 2021-04-09 |