| NPI | 1104472166 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH SIEFERT Pharmacist In Charge 251-747-1253 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2019-08-15 |
| Last Update Date | 2019-10-29 |