| NPI | 1366064511 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZACHERY WARRINGTON Pharmacist In Charge 662-719-6895 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Enumeration Date | 2020-05-11 |
| Last Update Date | 2020-05-11 |