| NPI | 1811763378 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP WILKINS Managing Member 870-351-0846 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| 3336L0003X Pharmacy, Long Term Care Pharmacy | |
| Enumeration Date | 2023-11-27 |
| Last Update Date | 2024-04-11 |