| NPI | 1487901419 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS BONNER Owner/Pha RN Acist 662-242-2567 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: MS 11547/1.1) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2012-08-09 |
| Last Update Date | 2016-05-18 |