| NPI | 1629008859 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL SCOTT BYRD Pharmacist 601-825-8660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: MS 01619- 01.2) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MS 01619/01.2) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2012-12-18 |