| NPI | 1194889568 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIMMY L TUCKER CEO/President 662-837-7323 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: MS MS1326) |
| Additional Taxonomies | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2023-04-16 |