| NPI | 1306484092 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD L JOHNSON Pharmacist/Owner 307-333-2120 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy, Compounding Pharmacy |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2019-12-13 |
| Last Update Date | 2019-12-13 |