| NPI | 1326151739 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILL MATKINS GOOCH Pharmacist 662-534-4774 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MS 02138011) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2008-05-27 |