| NPI | 1356455349 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOE WEAVER President 903-885-0821 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: TX 25934) |
| Additional Taxonomies | 3336L0003X Pharmacy Long Term Care Pharmacy |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2013-08-23 |