| NPI | 1811364078 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA NICOLOFF A/R Manager 512-447-1799 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: TX 30256) |
| Enumeration Date | 2015-08-24 |
| Last Update Date | 2016-08-31 |