NPI | 1275528390 |
---|---|
Entity Type | Organization |
Authorized Contact | JUSTIN HEATH BURTON Representative Of The Estate 501-425-8835 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: AR AR13271) |
Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: AR 13271) |
332BX2000X Durable Medical Equipment & Medical Supplies Oxygen Equipment & Supplies (Licence: AR 13271) | |
3336L0003X Pharmacy Long Term Care Pharmacy | |
Enumeration Date | 2005-09-14 |
Last Update Date | 2024-09-04 |