| NPI | 1629091616 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIONEL HEIDINGSFELDER Pharmacist 228-867-1331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: MS 01345041) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2020-08-22 |