| NPI | 1518929785 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY EUGENE THOMAS Owner Pharmacist 601-428-5977 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MS 5123500001) |
| Enumeration Date | 2006-04-04 |
| Last Update Date | 2020-03-26 |