NPI | 1457803421 |
---|---|
Doing Business As | GULF SOUTH PHARMACY |
Entity Type | Organization |
Authorized Contact | JEFFREY POOLE Managing Officer 817-572-0009 |
Organization Subpart ? | Yes |
Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: LA PHY.007385) |
Additional Taxonomies | 333600000X Pharmacy |
Enumeration Date | 2016-10-26 |
Last Update Date | 2024-10-04 |