| NPI | 1376198796 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYAN HORNE Owner 360-787-7408 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| Enumeration Date | 2019-08-02 |
| Last Update Date | 2020-12-02 |