| NPI | 1811336738 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA BETH TEMPLE Officer 817-406-4546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: TX 28617) |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 333600000X Pharmacy | |
| 3336C0004X Pharmacy Compounding Pharmacy | |
| 3336L0003X Pharmacy Long Term Care Pharmacy | |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2024-05-29 |