| NPI | 1316267487 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CURTIS RAY COLBERT Owner 731-285-0844 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: TN 4771) |
| Enumeration Date | 2010-06-10 |
| Last Update Date | 2011-07-29 |