| NPI | 1548301344 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLA PRATT Business Office Manager 870-972-4016 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2024-03-18 |