| NPI | 1710477393 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOE GILLIS President 662-327-5202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: AL 114803) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2018-05-18 |
| Last Update Date | 2018-05-25 |