| NPI | 1295248672 |
|---|---|
| Doing Business As | SUPER 1 PHARMACY #645 |
| Entity Type | Organization |
| Authorized Contact | TRENT D BROOKSHIRE Exec VP Corporate Development 903-534-3000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: LA 007545) |
| Additional Taxonomies | 333600000X Pharmacy (Licence: LA 007545) |
| Enumeration Date | 2017-11-08 |
| Last Update Date | 2017-11-08 |