| NPI | 1730368762 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARA LE BLANE HOVER Owner 972-385-8006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy Compounding Pharmacy (Licence: TX 21330) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0003X Pharmacy Community/Retail Pharmacy | |
| Enumeration Date | 2007-10-26 |
| Last Update Date | 2007-11-01 |