| NPI | 1457479438 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MACK BENNIE HARRIS Co Owner Pharmacist 228-868-1036 |
| Organization Subpart ? | No |
| Primary Taxonomy | 347C00000X Private Vehicle (Licence: MS 265662521) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2020-08-22 |