| NPI | 1194317289 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILSON L KREZDORN President/Pharmacist 903-707-2034 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2021-02-09 |
| Last Update Date | 2021-04-16 |