| NPI | 1255593067 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSS SPIVEY Pharmacist In Charge 931-684-9987 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy, Compounding Pharmacy (Licence: TN 0000004147) |
| Additional Taxonomies | 3336S0011X Pharmacy, Specialty Pharmacy (Licence: TN 0000004147) |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2008-07-02 |