| NPI | 1417090093 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN HARTNESS COBB Pharmacy Supervisor 601-984-2058 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0002X Pharmacy Clinic Pharmacy (Licence: MS 02188) |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2007-09-07 |