| NPI | 1477117893 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW FINN Officer 817-442-0484 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 3336C0004X Pharmacy Compounding Pharmacy |
| 3336L0003X Pharmacy Long Term Care Pharmacy | |
| Enumeration Date | 2019-05-01 |
| Last Update Date | 2021-02-18 |