| NPI | 1487793097 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN R GIBSON Pharmacist 731-285-1711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: TN 343) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2025-03-26 |