| NPI | 1205489911 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATONYA BROWN Chief Financial Officer 984-974-1145 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Enumeration Date | 2019-07-22 |
| Last Update Date | 2024-08-12 |