| NPI | 1366013179 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTIE SHEREE MOORMAN Pharmacist/Owner 662-487-6268 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2021-07-02 |
| Last Update Date | 2022-06-01 |