| NPI | 1114929296 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD ANDREW MOFFETT Pharmacist In Charge/Owner 601-693-0033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: MS 03424-01MM) |
| Enumeration Date | 2005-06-02 |
| Last Update Date | 2022-04-27 |