| NPI | 1184186991 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW CHARLES GREEN Officer 469-486-1330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| Enumeration Date | 2019-04-01 |
| Last Update Date | 2021-04-01 |