| NPI | 1548255748 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS ELLIOTT VP / PIC 662-287-8062 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MS 002075059) |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2022-07-28 |