| NPI | 1679847636 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAJUAN M SIMPSON Manager 469-263-4549 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy Compounding Pharmacy |
| Additional Taxonomies | 183500000X Pharmacist |
| Enumeration Date | 2012-03-07 |
| Last Update Date | 2012-03-07 |