| NPI | 1649203365 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANK TANT Owner/PIC/AO 256-463-2197 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: AL 102545) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2021-05-20 |