| NPI | 1679568729 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL HOLIFIELD Owner 870-793-4179 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: AR AR14083) |
| Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy |
| 3336L0003X Pharmacy, Long Term Care Pharmacy | |
| Enumeration Date | 2005-09-14 |
| Last Update Date | 2018-12-26 |