| NPI | 1235642687 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONELL T BUSROE Pharmacist/Owner 606-505-5133 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2017-11-08 |
| Last Update Date | 2017-11-13 |