| NPI | 1255102166 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER LYNDEN HAMMONS Pharmacist In Charge 276-346-8850 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0002X Pharmacy Clinic Pharmacy |
| Enumeration Date | 2024-01-10 |
| Last Update Date | 2024-01-10 |