| NPI | 1255341079 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS WAYNE BENTON Pharmacy Manager 601-371-8662 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MS 03328) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2015-05-05 |