| NPI | 1598806143 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD EDWARD WALDEN President 662-328-8660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: MS 01790) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2020-08-22 |