| NPI | 1336544584 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMBER HAYCOX VP 870-210-9209 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy |
| Additional Taxonomies | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: AR AR18257) |
| Enumeration Date | 2014-10-30 |
| Last Update Date | 2022-02-09 |