| NPI | 1295786432 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA ANDERSON-KOCIAN Manager 903-675-7069 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: TX 02523) |
| Additional Taxonomies | 3336L0003X Pharmacy Long Term Care Pharmacy (Licence: TX 02523) |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TX 02523) | |
| 333600000X Pharmacy | |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2020-06-04 |