| NPI | 1578877296 |
|---|---|
| Doing Business As | MALLATT PHARMACY AND COSTUME 101 |
| Entity Type | Organization |
| Authorized Contact | JOHN MICHAEL FLINT CEO 608-310-9922 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: WI 9024-42) |
| Enumeration Date | 2010-08-05 |
| Last Update Date | 2010-08-05 |