| NPI | 1508661216 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLISON LAWSON Pharmacist, PIC 865-337-5887 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 3336C0004X Pharmacy Compounding Pharmacy |
| Enumeration Date | 2025-02-17 |
| Last Update Date | 2025-02-17 |