| NPI | 1306149141 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA BOONE Pharmacist In Charge 915-747-6545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: TX 6401) |
| Additional Taxonomies | 3336C0002X Pharmacy Clinic Pharmacy |
| Enumeration Date | 2010-12-17 |
| Last Update Date | 2015-07-15 |