| NPI | 1285422204 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BOLA SIDAROUS Owner / Pharmacist In Charge 501-604-8008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2025-04-29 |
| Last Update Date | 2025-04-29 |