| NPI | 1144874827 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON CALEB HOWELL Pharmacist In Charge 833-463-4679 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2019-07-30 |
| Last Update Date | 2019-08-08 |