| NPI | 1174568240 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RON HARRIS CEO Mang Member 662-327-4025 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: MS 07472) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0002X Pharmacy Clinic Pharmacy | |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2007-10-19 |