| NPI | 1104944289 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES PORTER Store Manager 214-327-8200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy, Compounding Pharmacy (Licence: TX 21510) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2007-09-12 |