| NPI | 1811744659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCUS JACKSON Manager 615-410-4790 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| Enumeration Date | 2024-04-30 |
| Last Update Date | 2024-05-01 |