| NPI | 1447729850 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWN SAMS Owner 903-758-6164 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 3336L0003X Pharmacy Long Term Care Pharmacy |
| 3336C0004X Pharmacy Compounding Pharmacy | |
| Enumeration Date | 2018-11-14 |
| Last Update Date | 2025-01-02 |