| NPI | 1467509307 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONITA GREEN President 712-378-2700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: IA 64) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2011-08-23 |