| NPI | 1235169103 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA BETH MARTIN Pharmacy Manager 870-777-2263 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: AR AR-0413649) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2011-05-16 |