| NPI | 1700925955 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY MCCRORY President 915-581-9655 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: TX 03322) |
| Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy (Licence: TX 03322) |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 335E00000X Prosthetic/Orthotic Supplier | |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2008-04-15 |