| NPI | 1740379080 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MALCOLM D. CLARK Pharmacist/Manager/Owner 931-823-5534 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: TN 0000001154) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2020-08-22 |