| NPI | 1285702159 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT LEE LOGAN Pharmacist Owner 662-983-7800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2020-08-22 |