NPI | 1205847886 |
---|---|
Entity Type | Organization |
Authorized Contact | MICHELLE CLARK PIC 817-394-2318 |
Organization Subpart ? | No |
Primary Taxonomy | 333600000X Pharmacy (Licence: TX 24399) |
Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
Enumeration Date | 2006-08-10 |
Last Update Date | 2020-08-22 |