| NPI | 1851522155 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYAN SHEPHERD Chief Financial Officer 346-206-6785 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: TX 26531) | |
| 3336C0004X Pharmacy Compounding Pharmacy | |
| Enumeration Date | 2009-08-04 |
| Last Update Date | 2019-12-04 |