| NPI | 1164013603 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY WAYNE MULLINS Owner/Pharmacist 606-910-0555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2021-01-28 |
| Last Update Date | 2021-01-28 |