| NPI | 1225359664 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP KEITH WILKINS Pharmacy Owner 870-931-9263 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2010-06-21 |
| Last Update Date | 2010-06-21 |