| NPI | 1225787278 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVE LARRY WILSON PIC/Pharmacist/Owner 228-687-3040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2022-03-18 |
| Last Update Date | 2022-11-08 |