| NPI | 1295888394 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL ADETULA Chief Pharmacist 972-572-1939 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: TX 19614) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TX 1313330001) |
| 335E00000X Prosthetic/Orthotic Supplier (Licence: TX 19614) | |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2008-06-17 |