| NPI | 1497173983 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMMY PHILLIP CARSON Pharmacist / Director Of Pharmacy 662-315-5377 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2014-04-01 |
| Last Update Date | 2014-12-11 |