| NPI | 1295097335 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAJUAN M. SIMPSON Member 469-263-4549 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy Compounding Pharmacy |
| Additional Taxonomies | 261QI0500X Clinic/Center Infusion Therapy |
| Enumeration Date | 2012-06-14 |
| Last Update Date | 2012-07-20 |