| NPI | 1639180219 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLE ANDREW LOMAX President 870-275-9496 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: AR AR10314) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 333600000X Pharmacy | |
| 3336L0003X Pharmacy Long Term Care Pharmacy (Licence: AR AR10314) | |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2020-09-28 |