| NPI | 1285856740 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN TRAVIS HALL Owner 662-963-2367 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MS 00489 01.1) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2008-07-09 |