| NPI | 1831274125 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL R LONG Owner/PIC 479-782-8209 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: AR AR20332) |
| Additional Taxonomies | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2025-06-20 |