| NPI | 1508112889 |
|---|---|
| Doing Business As | MACK BAYOU PHARMACY LLC |
| Entity Type | Organization |
| Authorized Contact | AMY FRAZIER Owner 850-622-0730 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy, Compounding Pharmacy (Licence: FL PH26321) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| 333600000X Pharmacy | |
| Enumeration Date | 2012-07-24 |
| Last Update Date | 2017-03-01 |