| NPI | 1245744630 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHNIE PAUL NIXON Pharmacist In Charge 270-407-3434 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: KY P07863) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2017-11-22 |
| Last Update Date | 2022-05-12 |