| NPI | 1740807700 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FUZIE TANGYIE Pharmacist In Charge 940-536-0460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Enumeration Date | 2020-06-25 |
| Last Update Date | 2020-06-25 |