| NPI | 1245799857 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA EUGENA TYSON Pharmacist/Owner 229-316-8200 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy |
| Enumeration Date | 2019-03-14 |
| Last Update Date | 2019-04-04 |