| NPI | 1710099700 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANNY PONDER Owner 870-425-5145 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: AR AR20338) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2007-07-31 |