| NPI | 1245860535 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA T DOMINIC Pharmacist 940-226-4849 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| Enumeration Date | 2020-01-25 |
| Last Update Date | 2020-01-25 |