| NPI | 1295220598 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID POCHE Pharmacist 662-290-3000 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: MS 806) |
| Additional Taxonomies | 3336I0012X Pharmacy Institutional Pharmacy |
| Enumeration Date | 2018-06-28 |
| Last Update Date | 2022-11-10 |