| NPI | 1700172087 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANCE OGLESBEE President 903-389-2541 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy (Licence: TX 27530) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0004X Pharmacy Compounding Pharmacy | |
| Enumeration Date | 2011-06-24 |
| Last Update Date | 2012-01-10 |