| NPI | 1841941093 |
|---|---|
| Doing Business As | MOULTRIE PHARMACY AT CADDO |
| Entity Type | Organization |
| Authorized Contact | BENJAMIN DAVID MOULTRIE Owner 256-566-3174 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2022-01-10 |
| Last Update Date | 2022-01-10 |