| NPI | 1619204328 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TABITHA ANNE CARREON Staff Pharmacist 915-276-8764 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: TX 45270) |
| Enumeration Date | 2009-11-17 |
| Last Update Date | 2009-11-17 |