| NPI | 1760757082 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID JASON RUTLAND President 601-218-0005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy Compounding Pharmacy (Licence: FL PH26011) |
| Enumeration Date | 2012-03-20 |
| Last Update Date | 2012-03-20 |