| NPI | 1629795299 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY LEN BROOKS Owner 304-552-1591 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy |
| 3336M0002X Pharmacy, Mail Order Pharmacy | |
| Enumeration Date | 2022-10-25 |
| Last Update Date | 2022-10-25 |