| NPI | 1740649995 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLAS LADNER Owner 228-354-9616 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 3336C0004X Pharmacy Compounding Pharmacy | |
| Enumeration Date | 2016-02-16 |
| Last Update Date | 2020-07-28 |