| NPI | 1861611170 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FT COUTS Owner 374-429-7703 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MO 003480) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2007-09-12 |