| NPI | 1629083217 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY LINZY PIC 870-538-5503 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: AR AR 20331) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy | |
| 3336L0003X Pharmacy, Long Term Care Pharmacy | |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2020-08-22 |