NPI | 1487784674 |
---|---|
Doing Business As | SUPER VALLUE PHARMACY |
Entity Type | Organization |
Authorized Contact | JAYNE LAUGHBAUM General Manager 817-283-7300 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0004X Pharmacy, Compounding Pharmacy (Licence: TX 16368) |
Enumeration Date | 2007-03-06 |
Last Update Date | 2009-09-29 |