| NPI | 1518697200 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRESTON JETT JONES Pharmacist In Charge 870-935-1340 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy |
| Enumeration Date | 2022-06-15 |
| Last Update Date | 2022-06-23 |