| NPI | 1710171079 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM POWELL Owner And PIC No 12992 361-853-0396 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: TX 02532) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2007-08-30 |
| Last Update Date | 2007-08-30 |