NPI | 1811236375 |
---|---|
Entity Type | Organization |
Authorized Contact | TOMMY JOE WOODARD Pharmacist In Charge 225-615-8730 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
Enumeration Date | 2013-02-04 |
Last Update Date | 2024-12-10 |