| NPI | 1245554559 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLINT EUGENE BANE Owner/Pharmacist 601-833-3160 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MS 3336C0003X) |
| Enumeration Date | 2010-03-16 |
| Last Update Date | 2010-03-16 |