| NPI | 1295800878 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEA ANN BARRON Gm 903-526-8030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: TX 25313) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2009-04-15 |