| NPI | 1154599355 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEE PARKS President 877-827-1288 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: AL 113050) |
| Additional Taxonomies | 3336C0004X Pharmacy Compounding Pharmacy |
| Enumeration Date | 2008-02-11 |
| Last Update Date | 2014-04-03 |