| NPI | 1770136806 |
|---|---|
| Doing Business As | SOUTHERN STAR PHARMACY 003 |
| Entity Type | Organization |
| Authorized Contact | TREY AUSTIN Managing Member 469-247-3881 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2019-07-17 |
| Last Update Date | 2021-10-01 |