| NPI | 1104911221 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE PITALO Owner 228-432-7071 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MS 05972) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2017-03-10 |