| NPI | 1124169057 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENN D BRANTLEY Vice President. Secretary Treasure 601-346-5567 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MS 02268 01.1) |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2007-08-21 |