| NPI | 1760569198 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIK BROOME Pharmacist 662-563-4557 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: MS 00856) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2008-11-20 |