| NPI | 1538400296 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADAM C BOHUSLAV Pharmacy Manager 512-828-0814 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: TX 48872) |
| Enumeration Date | 2013-03-06 |
| Last Update Date | 2018-07-19 |