| NPI | 1114040391 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA NICOLOFF Accounts Receivable 512-447-1799 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: TX 05895) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2016-08-31 |