| NPI | 1568228476 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LANCE FREEMAN Owner 620-220-6161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| 3336L0003X Pharmacy, Long Term Care Pharmacy | |
| Enumeration Date | 2024-02-27 |
| Last Update Date | 2024-02-27 |