| NPI | 1467474411 |
|---|---|
| Doing Business As | DESOTO DRUG STORE |
| Entity Type | Organization |
| Authorized Contact | DONALD RAY HOUSTON President 386-752-1793 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: FL PH630) |
| Additional Taxonomies | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: FL PH630) |
| 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: FL PH630) | |
| 335E00000X Prosthetic/Orthotic Supplier (Licence: FL PH630) | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2023-03-07 |