| NPI | 1841867421 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | MARK GARY FETCENKO COO 713-660-8888 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy | 
| Additional Taxonomies | 3336S0011X Pharmacy, Specialty Pharmacy | 
| Enumeration Date | 2021-06-10 | 
| Last Update Date | 2021-06-10 |