| NPI | 1588080881 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACI TRON Office Manager 662-449-3200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336M0002X Pharmacy Mail Order Pharmacy (Licence: MS F12216) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MS F11493) |
| Enumeration Date | 2014-03-11 |
| Last Update Date | 2014-03-11 |