NPI | 1821608134 |
---|---|
Entity Type | Organization |
Authorized Contact | LANAESHA TOLES Pharmacist In Charge 662-712-1478 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
Enumeration Date | 2020-08-03 |
Last Update Date | 2021-08-25 |