| NPI | 1457418139 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY LEE HOLT Controller 601-981-0070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MS 0682202.3) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2008-01-02 |