| NPI | 1831565852 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANDY LEACH Pharmacist In Charge 888-333-1290 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: MS 14439) |
| Enumeration Date | 2015-08-13 |
| Last Update Date | 2015-11-11 |