| NPI | 1366583205 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL TODD COSPELICH Pharmacist Manager 662-628-5000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MS E7662) |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2013-01-24 |