| NPI | 1467546341 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY MARTHA TABOR President/Pharmacist 662-773-5363 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MS 00572/01.1) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2015-04-16 |