| NPI | 1386147627 |
|---|---|
| Doing Business As | SUPER 1 PHARMACY #648 |
| Entity Type | Organization |
| Authorized Contact | NEIL F DUCOTE VP Pharmacy 903-534-3478 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: LA 006546) |
| Additional Taxonomies | 333600000X Pharmacy (Licence: LA 006546) |
| Enumeration Date | 2018-03-13 |
| Last Update Date | 2023-02-14 |