| NPI | 1548826563 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY MELVIN BOONE Pharmacist/Owner 601-795-4566 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2019-05-15 |
| Last Update Date | 2019-05-15 |