| NPI | 1205232881 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN ADAM LOCHRIDGE Pharmacy Manager 662-320-6836 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Enumeration Date | 2014-11-10 |
| Last Update Date | 2014-11-10 |