| NPI | 1528219318 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIKE ANDERSON President 210-226-1112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy Compounding Pharmacy (Licence: TX 26153) |
| Additional Taxonomies | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Enumeration Date | 2008-10-10 |
| Last Update Date | 2010-09-24 |