| NPI | 1659913010 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM CHRISTOPHER BONNER Pharmacist/Owner 662-570-1059 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2019-10-16 |
| Last Update Date | 2020-05-19 |