| NPI | 1124191697 |
|---|---|
| Doing Business As | SUPER 1 PHARMACY |
| Entity Type | Organization |
| Authorized Contact | JIM COUSINEAU VP Pharmacy Operations 903-877-6514 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: LA 4111) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2018-07-19 |