| NPI | 1588524532 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMBER LYNN MANNING Pharmacist 270-527-3135 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2025-11-13 |
| Last Update Date | 2025-11-13 |