| NPI | 1467532663 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL HENRY ROSE Owner 601-894-1222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 251K00000X Public Health or Welfare (Licence: MS 002093) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2020-12-23 |