| NPI | 1184733669 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN F COLBERT Exec Dir, Rx Services 800-746-7287 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: TX 20401) |
| Additional Taxonomies | 3336C0003X Pharmacy Community/Retail Pharmacy |
| 3336S0011X Pharmacy Specialty Pharmacy | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2024-06-12 |