| NPI | 1184801722 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY D SMITH Credentialing Specialist 901-260-8551 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0002X Pharmacy, Clinic Pharmacy (Licence: TN 4095) |
| Enumeration Date | 2008-01-25 |
| Last Update Date | 2008-01-25 |