| NPI | 1376797704 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAXINE WILSON Gm 972-243-2727 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TX 26217) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0003X Pharmacy Community/Retail Pharmacy | |
| Enumeration Date | 2008-11-12 |
| Last Update Date | 2023-05-08 |