NPI | 1275994501 |
---|---|
Entity Type | Organization |
Authorized Contact | LAURA LYNN WAGNER Owner 479-243-6169 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: AR AR16289) |
Enumeration Date | 2016-03-15 |
Last Update Date | 2016-03-15 |