| NPI | 1114047081 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWIN LAMAR BAKER Manager, Chief Pharmacist 601-833-6361 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MS 00104 01.1) |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2020-08-22 |