| NPI | 1386373405 |
|---|---|
| Doing Business As | SUPER 1 PHARMACY #650 |
| Entity Type | Organization |
| Authorized Contact | NEIL DUCOTE VP Pharmacy Ops 903-600-1376 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2022-06-06 |
| Last Update Date | 2022-06-06 |