| NPI | 1790348100 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA CASTEEL CEO 731-644-8478 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336I0012X Pharmacy, Institutional Pharmacy |
| Additional Taxonomies | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2019-04-22 |
| Last Update Date | 2020-05-19 |