| NPI | 1265907109 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN LANGFORD Legal Assistant 469-942-9015 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336S0011X Pharmacy, Specialty Pharmacy |
| Additional Taxonomies | 3336M0002X Pharmacy, Mail Order Pharmacy |
| Enumeration Date | 2018-10-08 |
| Last Update Date | 2025-01-06 |