| NPI | 1104847177 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRAYSON HANKINS President 432-366-8821 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: TX 24948) |
| Additional Taxonomies | 3336C0004X Pharmacy Compounding Pharmacy |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 333600000X Pharmacy | |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2017-02-20 |