| NPI | 1306906482 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL STUART CLARK Pharmacist Owner 662-843-6700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MS 05857) |
| 3336L0003X Pharmacy, Long Term Care Pharmacy | |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2018-03-20 |