| NPI | 1700924792 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANDA HABA Ofc Mngr 662-256-5662 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MS 646) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2007-09-12 |