| NPI | 1760924088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZACH HOLDERFIELD Partner 870-814-0605 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: AR AR20856) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0003X Pharmacy, Community/Retail Pharmacy | |
| Enumeration Date | 2016-11-17 |
| Last Update Date | 2022-07-21 |