| NPI | 1831743632 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW SCOTT VILLIARD Pharmacist 276-321-0088 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Enumeration Date | 2019-07-30 |
| Last Update Date | 2019-11-07 |