| NPI | 1205080975 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATALIE MAINELLI Pharmacy Manager 662-294-1111 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 333600000X Pharmacy (Licence: MS 07944/02.0) |
| Enumeration Date | 2008-11-07 |
| Last Update Date | 2008-11-07 |