| NPI | 1659853422 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES MATTHEW VO Managing Member 281-685-7279 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| Enumeration Date | 2018-08-29 |
| Last Update Date | 2018-08-29 |