| NPI | 1225046956 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC PENDARVIS PIC 806-795-8555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0002X Pharmacy Clinic Pharmacy |
| Additional Taxonomies | 3336C0003X Pharmacy Community/Retail Pharmacy |
| 3336M0002X Pharmacy Mail Order Pharmacy | |
| 3336S0011X Pharmacy Specialty Pharmacy | |
| 333600000X Pharmacy (Licence: TX 11706) | |
| 3336C0004X Pharmacy Compounding Pharmacy | |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2020-08-22 |