| NPI | 1104989714 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DON REED Owner 712-624-8160 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: IA 511) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2007-07-19 |