| NPI | 1215824933 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TALMAGE JEREMY WHITEHEAD CFO 870-347-2534 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 3336L0003X Pharmacy Long Term Care Pharmacy |
| 333600000X Pharmacy | |
| Enumeration Date | 2025-06-24 |
| Last Update Date | 2025-06-24 |