| NPI | 1336225002 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASEN TATE CREEK Pharmacist In Charge 903-792-1721 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: TX 23886) |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2012-08-27 |