| NPI | 1356450100 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | R NORRIS RAGAN Pharmacist Owner 870-673-2741 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician (Licence: AR L0239) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AR PD05278) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2020-08-22 |