| NPI | 1831115781 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLIFTON GANT VP Of Ops 662-342-8527 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: MS 926) |
| Additional Taxonomies | 3336S0011X Pharmacy, Specialty Pharmacy |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2020-08-22 |