| NPI | 1255474102 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLE AARON MAULDIN Pharmacist Owener 601-428-7257 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MS 01527 01.1) |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2020-08-22 |