| NPI | 1578334751 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY DON MOONEYHAM Pharmacist In Charge 870-932-4742 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy |
| Enumeration Date | 2024-01-16 |
| Last Update Date | 2024-01-16 |