| NPI | 1316032428 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSELL CLEVE WEST Owner/PIC 409-994-3578 |
| Organization Subpart ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 15224) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 19231) |
| 183700000X Pharmacy Technician (Licence: TX 116106) | |
| 183700000X Pharmacy Technician (Licence: TX 112330) | |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2023-03-07 |