| NPI | 1225142219 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUG BENEDETTI PIC 903-534-8218 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy (Licence: TX 17039) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2025-09-11 |