| NPI | 1528141736 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT EUGENE SHUTT Owner/Pharmacist 731-925-4932 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: TN 1428) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2010-11-15 |