NPI | 1790113538 |
---|---|
Entity Type | Organization |
Authorized Contact | LAUREN BROOKE DENTON Pharmacist 870-678-3004 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0004X Pharmacy Compounding Pharmacy |
Additional Taxonomies | 3336C0003X Pharmacy Community/Retail Pharmacy |
Enumeration Date | 2013-10-14 |
Last Update Date | 2013-10-14 |