| NPI | 1477530368 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIM PURSER Staff 806-791-0220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: TX 21396) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2005-12-30 |
| Last Update Date | 2010-11-22 |