| NPI | 1306888755 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAY TEAGUE VP 903-785-8750 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: TX 21363) |
| Additional Taxonomies | 3336M0002X Pharmacy Mail Order Pharmacy |
| 333600000X Pharmacy | |
| Enumeration Date | 2006-06-11 |
| Last Update Date | 2015-11-09 |