| NPI | 1780187021 |
|---|---|
| Doing Business As | SUPER 1 PHARMACY #639 |
| Entity Type | Organization |
| Authorized Contact | NEIL F DUCOTE Director Pharmacy Operations 903-534-3478 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: LA 006543) |
| Additional Taxonomies | 333600000X Pharmacy (Licence: LA 006543) |
| Enumeration Date | 2018-03-13 |
| Last Update Date | 2018-03-13 |