NPI | 1114563319 |
---|---|
Entity Type | Organization |
Authorized Contact | NATHANIEL ADAMS Pharmacist 270-370-0005 |
Organization Subpart ? | No |
Primary Taxonomy | 333600000X Pharmacy |
Additional Taxonomies | 3336S0011X Pharmacy, Specialty Pharmacy |
Enumeration Date | 2019-11-22 |
Last Update Date | 2021-01-05 |