| NPI | 1184745630 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKIE ELLINGTON Pharmacist 662-289-2312 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MS E6737) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2008-06-20 |