| NPI | 1689368037 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEERTHI MANOSE KONDAMURI Secretary 903-413-2196 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2023-06-07 |
| Last Update Date | 2023-06-07 |